Provider Demographics
NPI:1235192808
Name:REEDY, KAREN J (PA-C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:REEDY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 MT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3051
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:2058 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4829
Practice Address - Country:US
Practice Address - Phone:888-520-5060
Practice Address - Fax:717-812-3950
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001458363AS0400X
PAMA054384363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2557694OtherHIGHMARK BLUE SHIELD-FREEDOM BLUE
PA1602514OtherGATEWAY MEDICARE ASSURED
PA278701FLTMedicare PIN