Healthcare Provider Details

I. General information

NPI: 1336237973
Provider Name (Legal Business Name): AJIT M CHIKARMANE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 N LAUREL ST SUITE 2B
HAZLETON PA
18201
US

IV. Provider business mailing address

20 N LAUREL ST SUITE 2B
HAZLETON PA
18201
US

V. Phone/Fax

Practice location:
  • Phone: 570-454-5715
  • Fax: 570-455-5095
Mailing address:
  • Phone: 570-454-5715
  • Fax: 570-455-5095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberM0027889E
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: