Provider Demographics
NPI:1992777536
Name:IASIELLO, ANNETTE DENISE (PA-C, MS)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:DENISE
Last Name:IASIELLO
Suffix:
Gender:F
Credentials:PA-C, MS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:500 ST LUKES DR
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-5000
Mailing Address - Country:US
Mailing Address - Phone:484-526-6643
Mailing Address - Fax:
Practice Address - Street 1:500 ST. LUKE'S WAY
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235
Practice Address - Country:US
Practice Address - Phone:484-526-6643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051118363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant