Healthcare Provider Details

I. General information

NPI: 1811376320
Provider Name (Legal Business Name): ANASTASIA J LAPIKAS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANASTASIA J REYNOLDS PA-C

II. Dates (important events)

Enumeration Date: 05/29/2015
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7620 SOUTHERN BLVD STE 1
YOUNGSTOWN OH
44512-5667
US

IV. Provider business mailing address

7620 SOUTHERN BLVD STE 1
YOUNGSTOWN OH
44512-5667
US

V. Phone/Fax

Practice location:
  • Phone: 330-629-2144
  • Fax: 330-629-2140
Mailing address:
  • Phone: 330-629-2144
  • Fax: 330-629-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.004279RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA057569
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: