Provider Demographics
NPI:1134287261
Name:B.R.CHEKKA M.D,P.C.
Entity Type:Organization
Organization Name:B.R.CHEKKA M.D,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEKKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-454-2891
Mailing Address - Street 1:1611 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-2109
Mailing Address - Country:US
Mailing Address - Phone:814-454-2891
Mailing Address - Fax:
Practice Address - Street 1:1611 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-2109
Practice Address - Country:US
Practice Address - Phone:814-454-2891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038253L261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty