Provider Demographics
NPI:1477521623
Name:GOKHALE, CHINTAMANI BHASKAR (MD)
Entity Type:Individual
Prefix:DR
First Name:CHINTAMANI
Middle Name:BHASKAR
Last Name:GOKHALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 STOCK ST STE 83
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2276
Mailing Address - Country:US
Mailing Address - Phone:717-316-3030
Mailing Address - Fax:717-316-1617
Practice Address - Street 1:310 STOCK ST STE 83
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-2276
Practice Address - Country:US
Practice Address - Phone:717-316-3030
Practice Address - Fax:717-316-1617
Is Sole Proprietor?:No
Enumeration Date:2006-03-12
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA46227207RG0100X
PAMD037788L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA30333OtherHARVARD-PILGRIM HEALTHCAR
MA706375OtherTUFTS HEALTH PLAN-INDIVIS
MA0129445Medicaid
PA103770180Medicaid
MA706375OtherTUFTS HEALTH PLAN-INDIVIS