Healthcare Provider Details

I. General information

NPI: 1598159840
Provider Name (Legal Business Name): JASON PETER ASSALITA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2015
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 E CHOCOLATE AVE STE 400
HERSHEY PA
17033-1242
US

IV. Provider business mailing address

720 NORMAN DR
LEBANON PA
17042-7481
US

V. Phone/Fax

Practice location:
  • Phone: 717-256-2131
  • Fax: 949-864-3991
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS019240
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberOS019240
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: