Provider Demographics
NPI:1619097003
Name:CHADRAN, ACHJAN (MPT)
Entity Type:Individual
Prefix:
First Name:ACHJAN
Middle Name:
Last Name:CHADRAN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2123
Mailing Address - Country:US
Mailing Address - Phone:724-940-3990
Mailing Address - Fax:724-940-3993
Practice Address - Street 1:1033 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2123
Practice Address - Country:US
Practice Address - Phone:724-940-3990
Practice Address - Fax:724-940-3993
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA703833OtherINDIVIDUAL BLUE SHIELD
PA561758OtherGROUP BLUE SHIELD
PA872651OtherHEALTH AMERICA
PA561758OtherGROUP BLUE SHIELD
PA023975Medicare ID - Type UnspecifiedGROUP NUMBER