Provider Demographics
NPI:1093779332
Name:CHIEPPA, DAMIAN J (PT)
Entity Type:Individual
Prefix:
First Name:DAMIAN
Middle Name:J
Last Name:CHIEPPA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:24 ROYAL PALM DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-7905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 POWERS AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5933
Practice Address - Country:US
Practice Address - Phone:717-920-4950
Practice Address - Fax:717-920-4955
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT01385L225100000X
AZ6758225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102371R9XMedicare Oscar/Certification