Healthcare Provider Details

I. General information

NPI: 1881325330
Provider Name (Legal Business Name): LOKENDRA CHHANTYAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2022
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S. WASHINGTON AVE.
SCRANTON PA
18505
US

IV. Provider business mailing address

12500 WILLOWBROOK RD
CUMBERLAND MD
21502-6393
US

V. Phone/Fax

Practice location:
  • Phone: 570-866-3058
  • Fax:
Mailing address:
  • Phone: 443-830-7248
  • Fax: 570-343-4800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0102159
License Number StateMD

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: