Provider Demographics
NPI:1306820170
Name:CHALASANI, GEETHA (MBBS)
Entity Type:Individual
Prefix:DR
First Name:GEETHA
Middle Name:
Last Name:CHALASANI
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 TERRACE STREET
Mailing Address - Street 2:A919 SCAIFE HALL
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15261
Mailing Address - Country:US
Mailing Address - Phone:412-586-9872
Mailing Address - Fax:412-586-9876
Practice Address - Street 1:3550 TERRACE ST
Practice Address - Street 2:A915 SCAIFE HALL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-0001
Practice Address - Country:US
Practice Address - Phone:412-647-7157
Practice Address - Fax:412-647-6222
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043832207RN0300X
PAMD-429308207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
136695Medicare UPIN