Provider Demographics
NPI:1134329063
Name:RANDEREE, RASHIDA (DO)
Entity type:Individual
Prefix:
First Name:RASHIDA
Middle Name:
Last Name:RANDEREE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 SHARON NEW CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:FARRELL
Mailing Address - State:PA
Mailing Address - Zip Code:16121-1576
Mailing Address - Country:US
Mailing Address - Phone:724-981-8070
Mailing Address - Fax:724-704-7418
Practice Address - Street 1:350 SHARON NEW CASTLE RD
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1576
Practice Address - Country:US
Practice Address - Phone:724-981-8070
Practice Address - Fax:724-704-7418
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS021721207V00000X
DEC2-0009401207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1040010009Medicaid
DE1134329063Medicaid