Provider Demographics
NPI:1326365800
Name:CHIMAHOSKY INTERNAL MEDICINE PC
Entity Type:Organization
Organization Name:CHIMAHOSKY INTERNAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIMAHOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-622-1910
Mailing Address - Street 1:1720 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-2141
Mailing Address - Country:US
Mailing Address - Phone:570-622-1910
Mailing Address - Fax:570-622-5030
Practice Address - Street 1:1720 W MARKET ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-2141
Practice Address - Country:US
Practice Address - Phone:570-622-1910
Practice Address - Fax:570-622-5030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty