Healthcare Provider Details

I. General information

NPI: 1134112741
Provider Name (Legal Business Name): TESSA HAYES CHOPRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TESSA HAYES CHOPRA MD

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CARLISLE ST
NATRONA HEIGHTS PA
15065-1152
US

IV. Provider business mailing address

1301 CARLISLE ST DEPT OF
NATRONA HEIGHTS PA
15065-1152
US

V. Phone/Fax

Practice location:
  • Phone: 724-224-5100
  • Fax:
Mailing address:
  • Phone: 724-224-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number001300-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD470701
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: