Healthcare Provider Details

I. General information

NPI: 1902836612
Provider Name (Legal Business Name): CATHERINE CHODKIEWICZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MULBERRY ST
SCRANTON PA
18510-2369
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-9403
US

V. Phone/Fax

Practice location:
  • Phone: 570-703-8000
  • Fax: 570-703-8002
Mailing address:
  • Phone: 570-703-8000
  • Fax: 570-703-8002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number36825
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD424139
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number36825
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: