Provider Demographics
NPI:1386685550
Name:ASTL-REIMER, PAMELA JANE (PA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JANE
Last Name:ASTL-REIMER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:PAMEL
Other - Middle Name:JANE
Other - Last Name:ASTL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1021 PARK AVE.
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951
Mailing Address - Country:US
Mailing Address - Phone:215-538-4573
Mailing Address - Fax:215-588-4574
Practice Address - Street 1:1021 PARK AVE.
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951
Practice Address - Country:US
Practice Address - Phone:215-538-4573
Practice Address - Fax:215-588-4574
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051093L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA051093LOtherPA LICENSE
PAMA051093LOtherPA LICENSE
PAMA051093LOtherPA LICENSE