Provider Demographics
NPI:1609080175
Name:RASO, JON A (MD)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:A
Last Name:RASO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:#10 MOUNT BETHEL PLAZA
Mailing Address - City:MOUNT BETHEL
Mailing Address - State:PA
Mailing Address - Zip Code:18343-0043
Mailing Address - Country:US
Mailing Address - Phone:570-897-7559
Mailing Address - Fax:
Practice Address - Street 1:#10 MOUNT BETHEL PLAZA
Practice Address - Street 2:
Practice Address - City:MOUNT BETHEL
Practice Address - State:PA
Practice Address - Zip Code:18343-0043
Practice Address - Country:US
Practice Address - Phone:570-897-7559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053686L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA016578217OtherHIGHMARK BC BS
P853307OtherOXFORD
5843921OtherCIGNA HEALTHCARE
110130795OtherPALMETTO GBA - RAILROAD MEDICARE
PA50017380OtherCAPITAL BLUE CROSS
5843921OtherCIGNA HEALTHCARE
PA50017380OtherCAPITAL BLUE CROSS