Provider Demographics
NPI:1992739197
Name:PASDON, REBECCA L (DO)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:PASDON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4000
Practice Address - Fax:215-807-8235
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012406207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA8888570OtherCIGNA
PA452729OtherAETNA CONTRACT
PAP00289623OtherRAILROAD MEDICARE
PA101432961-01OtherAMERICHOICE FRANKFORD
PA1779119OtherHIGHMARK BLUE SHIELD
PA1014329610002Medicaid
PA30028704OtherKEYSTONE MERCY
PA101432961-03OtherAMERICHOICE TORRESDALE
PA101432961-02OtherAMERICHOICE BUCKS
PA2459388000OtherKEYSTONE IBC
PA1779119OtherPERSONAL CHOICE
PA07645OtherHEALTH PARTNERS
PA1014329610001Medicaid
PA1014329610003Medicaid
PA30028704OtherKEYSTONE MERCY
PAP00289623OtherRAILROAD MEDICARE