Healthcare Provider Details

I. General information

NPI: 1891749578
Provider Name (Legal Business Name): STEPHANIE ANN CHUIPEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 FAIRVIEW RD SUITE 210
SWARTHMORE PA
19081-2334
US

IV. Provider business mailing address

630 FAIRVIEW RD SUITE 210
SWARTHMORE PA
19081-2334
US

V. Phone/Fax

Practice location:
  • Phone: 610-541-0155
  • Fax: 610-541-0158
Mailing address:
  • Phone: 610-541-0155
  • Fax: 610-541-0158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD032786E
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier814343
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA
# 2
Identifier1079506
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerKEYSTONE MERCY
# 3
Identifier539846
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CROSS
# 4
Identifier0115790001
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerKEYSTONE HEALTH PLAN EAST
# 5
Identifier1049219439
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHEALTH PARTNERS
# 6
Identifier1232108
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: