Provider Demographics
NPI:1104126325
Name:AJIT M CHIKARMANE MD PC
Entity type:Organization
Organization Name:AJIT M CHIKARMANE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AJIT
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHIKARMANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-454-5715
Mailing Address - Street 1:20 N LAUREL ST
Mailing Address - Street 2:2B
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-5948
Mailing Address - Country:US
Mailing Address - Phone:570-454-5715
Mailing Address - Fax:570-455-5095
Practice Address - Street 1:20 N LAUREL ST
Practice Address - Street 2:2B
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-5948
Practice Address - Country:US
Practice Address - Phone:570-454-5715
Practice Address - Fax:570-455-5095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027889E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017877850002Medicaid
PA195234Medicare PIN
PA0017877850002Medicaid
PA195324Medicare PIN
195234Medicare PIN
PAB41076Medicare UPIN
B41076Medicare UPIN