Healthcare Provider Details

I. General information

NPI: 1396990347
Provider Name (Legal Business Name): DR. PADMAJA CHILAKAPATI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NEW SALEM ROAD SUITE 116
UNIONTOWN PA
15401
US

IV. Provider business mailing address

100 NEW SALEM ROAD SUITE 116
UNIONTOWN PA
15401
US

V. Phone/Fax

Practice location:
  • Phone: 724-437-0729
  • Fax: 724-437-2761
Mailing address:
  • Phone: 724-437-0729
  • Fax: 724-437-2761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD432776
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: