Provider Demographics
NPI:1275530958
Name:ASTARITA, TERASA M (CRNP)
Entity Type:Individual
Prefix:
First Name:TERASA
Middle Name:M
Last Name:ASTARITA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3500
Mailing Address - Fax:717-544-3501
Practice Address - Street 1:2112 HARRISBURG PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3500
Practice Address - Fax:717-544-3501
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP006313C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA07590446Medicaid
PA500012585OtherRAILROAD MEDICARE
PAP06629Medicare UPIN
PA037726JW2Medicare PIN