Provider Demographics
NPI:1124273578
Name:CHHABRA, ASHOK KUMAR (PSYD)
Entity type:Individual
Prefix:
First Name:ASHOK
Middle Name:KUMAR
Last Name:CHHABRA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 ROUTE 115
Mailing Address - Street 2:
Mailing Address - City:SAYLORSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18353-8338
Mailing Address - Country:US
Mailing Address - Phone:570-350-4475
Mailing Address - Fax:570-992-7150
Practice Address - Street 1:651 ROUTE 115
Practice Address - Street 2:
Practice Address - City:SAYLORSBURG
Practice Address - State:PA
Practice Address - Zip Code:18353-8338
Practice Address - Country:US
Practice Address - Phone:570-350-4475
Practice Address - Fax:570-992-7150
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-27
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017872-1103TC0700X
PAPS016769103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical