=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013374735
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JUDITH LYNN CHIGER M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/26/2016
-----------------------------------------------------
Last Update Date | 02/26/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10125 VERREE RD SUITE 203
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19116-3611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-302-2003
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10125 VERREE RD SUITE 203
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19116-3611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-302-2003
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LH0002X
-----------------------------------------------------
Taxonomy Name | Hospice and Palliative Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | MD046302L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | MD046302L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------