Healthcare Provider Details

I. General information

NPI: 1073969499
Provider Name (Legal Business Name): AASIA FERDOUS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2016
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HUNTINGDON PIKE STE C
ROCKLEDGE PA
19046-4431
US

IV. Provider business mailing address

400 HUNTINGDON PIKE STE C
ROCKLEDGE PA
19046-4431
US

V. Phone/Fax

Practice location:
  • Phone: 215-780-2000
  • Fax: 215-780-2007
Mailing address:
  • Phone: 215-780-2000
  • Fax: 215-780-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number30125450
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberOS020353
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS020353
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: