MEDICARE: MR. PASCHAL CHIKA OBI MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1174753925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PASCHAL CHIKA OBI MSW

Provider Business Mailing Address
First Line	:	2061 MICHENER ST
Second Line	:	APT 20
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-4363
Country	:	US
Telephone Number	:	267-334-5330
Fax Number	:

Provider Business Practice Location Address
First Line	:	2061 MICHENER ST
Second Line	:	APT 20
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-4363
Country	:	US
Telephone Number	:	267-334-5330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2009
Last Update Date	:	07/15/2009

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