Provider Demographics
NPI:1912012295
Name:ASSEFA, ASTER (MD)
Entity Type:Individual
Prefix:
First Name:ASTER
Middle Name:
Last Name:ASSEFA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 REMBRANDT CIR
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-9530
Mailing Address - Country:US
Mailing Address - Phone:724-861-4770
Mailing Address - Fax:
Practice Address - Street 1:603 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1006
Practice Address - Country:US
Practice Address - Phone:724-547-3030
Practice Address - Fax:724-547-4596
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD063307L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019211110002Medicaid
PA061338Medicare PIN
PAG57097Medicare UPIN