Provider Demographics
NPI:1376595553
Name:JANGDHARI, CHARLES ASOKA (DC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:ASOKA
Last Name:JANGDHARI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 AIRPORT ROAD
Mailing Address - Street 2:
Mailing Address - City:SMOKETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17576
Mailing Address - Country:US
Mailing Address - Phone:717-293-9748
Mailing Address - Fax:
Practice Address - Street 1:307 AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:SMOKETOWN
Practice Address - State:PA
Practice Address - Zip Code:17576
Practice Address - Country:US
Practice Address - Phone:717-299-1267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002272L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
2363940000OtherIBC
1736734OtherHIGHMARK
105719OtherASHN
2363940000OtherIBC
1736734OtherHIGHMARK