Provider Demographics
NPI:1437524030
Name:PASHA-RAZZAK, OMRANA (MBBS)
Entity Type:Individual
Prefix:
First Name:OMRANA
Middle Name:
Last Name:PASHA-RAZZAK
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:OMRANA
Other - Middle Name:
Other - Last Name:PASHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:CA410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-8161
Practice Address - Fax:717-531-4645
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD82665207P00000X
PAMD468997207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1036935820001Medicaid
MD623048Y9QOtherMEDICARE