Provider Demographics
NPI:1215036058
Name:RASO MEDICAL CENTER, PC
Entity Type:Organization
Organization Name:RASO MEDICAL CENTER, PC
Other - Org Name:DR DOMINICK J RASO MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-258-9091
Mailing Address - Street 1:124 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3218
Mailing Address - Country:US
Mailing Address - Phone:610-258-9091
Mailing Address - Fax:610-258-2992
Practice Address - Street 1:124 N 14TH ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3218
Practice Address - Country:US
Practice Address - Phone:610-258-9091
Practice Address - Fax:610-258-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2321000OtherCAPITAL BLUE CROSS
PA1412509OtherHIGHMARK BLUE SHIELD
PADH1635OtherRAILROAD MEDICARE
PA511930OtherAETNA U.S. HEALTHCARE
PADH1635OtherRAILROAD MEDICARE