Provider Demographics
NPI:1124001128
Name:BEEDASSY, ASHOK (MD)
Entity Type:Individual
Prefix:
First Name:ASHOK
Middle Name:
Last Name:BEEDASSY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 HARRISBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3600
Mailing Address - Fax:717-544-3604
Practice Address - Street 1:2102 HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3600
Practice Address - Fax:717-544-3604
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055479L207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017716220001Medicaid
PA02085202OtherCAPITAL BLUE CROSS
PA2229429OtherAETNA HMO
PAH07080OtherHEALTH ASSURANCE
PA1518639OtherGATEWAY HEALTH PLAN
PA7309033OtherAETNA NON-HMO
PA739605OtherHIGHMARK BLUE SHIELD
PAH07080Medicare UPIN
PA0017716220001Medicaid