Provider Demographics
NPI:1396117420
Name:CHECHAK, THOMAS STEPHEN (CRNP)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:STEPHEN
Last Name:CHECHAK
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 FABER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15214-2136
Mailing Address - Country:US
Mailing Address - Phone:412-322-0636
Mailing Address - Fax:
Practice Address - Street 1:1719 UNION AVE STE A
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2146
Practice Address - Country:US
Practice Address - Phone:724-226-2128
Practice Address - Fax:724-226-2498
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015349363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily