Provider Demographics
NPI:1467462119
Name:PASTICK, DION M (PA)
Entity type:Individual
Prefix:
First Name:DION
Middle Name:M
Last Name:PASTICK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 YORK RD
Mailing Address - Street 2:
Mailing Address - City:NEW OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:17350-9553
Mailing Address - Country:US
Mailing Address - Phone:717-624-1337
Mailing Address - Fax:
Practice Address - Street 1:455 S WASHINGTON ST STE 12
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2516
Practice Address - Country:US
Practice Address - Phone:717-339-2875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059780363AM0700X, 363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103562553Medicaid
WA0286522OtherWA L&I
WA8354474Medicaid
PA780596OtherMEDICARE
OR500635905Medicaid
WA0279420OtherWA L&I
WAG8903704Medicare PIN