Abdulla Jastaniah, DO

Individual provider Active NPI Internal Medicine Physician · Milton, PA

NPI 1982307153 · NPPES record last updated Apr 30, 2024

Key facts

NPI
1982307153
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
OT022703 (PA)
Practice address
155 S Arch St
Milton, PA 17847-1172
Phone
(570) 742-2655
Fax
(570) 742-2886
NPI assigned
Mar 24, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230708000052 PA Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
7911366968

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OT022703 PA
Internal Medicine Physician 207R00000X OT022703 PA Yes

Addresses

Primary practice location

155 S Arch St
Milton, PA 17847-1172

Mailing address

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6520

Other providers in Milton, PA

All providers in Milton, PA · Internal Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.