Provider Demographics
NPI:1679624829
Name:CHHABRIA, BHAVNA (MD)
Entity Type:Individual
Prefix:
First Name:BHAVNA
Middle Name:
Last Name:CHHABRIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUNITHA
Other - Middle Name:H
Other - Last Name:NICHANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:206 E BROWN ST
Mailing Address - Street 2:POCONO HEALTHCARE MGMT. - PROFESSIONAL BLDG.
Mailing Address - City:E STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-3006
Mailing Address - Country:US
Mailing Address - Phone:570-420-4969
Mailing Address - Fax:570-476-3754
Practice Address - Street 1:206 E BROWN ST
Practice Address - Street 2:POCONO HOSPITALISTS
Practice Address - City:E STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-3006
Practice Address - Country:US
Practice Address - Phone:570-421-4000
Practice Address - Fax:570-476-3754
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD424923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012130430001Medicaid
PAI26146Medicare UPIN
PA1012130430001Medicaid