Provider Demographics
NPI:1770577793
Name:ESPOSITO, RACHEL FASSON (DO)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:FASSON
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:FASSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:599 N CHURCH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-1004
Mailing Address - Country:US
Mailing Address - Phone:724-542-5349
Mailing Address - Fax:724-542-4658
Practice Address - Street 1:599 N CHURCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1004
Practice Address - Country:US
Practice Address - Phone:724-542-5349
Practice Address - Fax:724-542-4658
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101936986Medicaid
PA101287842Medicaid
PAI30854Medicare UPIN
PAP00300189OtherRAILROAD MEDICARE
PA1739255OtherHIGHMARK BC/BS
PA410798OtherUPMC HEALTHPLAN
PA091525Medicare PIN