Provider Demographics
NPI:1124059464
Name:CHARABATI, JIHAD (MD)
Entity type:Individual
Prefix:DR
First Name:JIHAD
Middle Name:
Last Name:CHARABATI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PECKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18452-2081
Mailing Address - Country:US
Mailing Address - Phone:570-307-7600
Mailing Address - Fax:570-383-5594
Practice Address - Street 1:1400 MAIN ST
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452-2081
Practice Address - Country:US
Practice Address - Phone:570-307-7600
Practice Address - Fax:570-383-5594
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035552E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001144865Medicaid
PAD71468Medicare UPIN
PA480108Medicare PIN