Provider Demographics
NPI:1033253117
Name:JEFFERY H CHABY DO ASSOCIATES
Entity Type:Organization
Organization Name:JEFFERY H CHABY DO ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHABY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-393-0200
Mailing Address - Street 1:200 BUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6305
Mailing Address - Country:US
Mailing Address - Phone:717-393-0200
Mailing Address - Fax:717-393-7071
Practice Address - Street 1:200 BUTLER AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6305
Practice Address - Country:US
Practice Address - Phone:717-393-0200
Practice Address - Fax:717-393-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004322L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC30631Medicare UPIN