Provider Demographics
NPI:1740265669
Name:CHIU, LOLITA EVANGELISTA (MD)
Entity type:Individual
Prefix:DR
First Name:LOLITA
Middle Name:EVANGELISTA
Last Name:CHIU
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:MC A410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:717-531-4633
Practice Address - Street 1:1301 CARLISLE STREET
Practice Address - Street 2:ALLE-KISKI MEDICAL CENTER
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1152
Practice Address - Country:US
Practice Address - Phone:724-224-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD419960207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019084320004Medicaid
OH2389393Medicaid
OH2389393Medicaid
PAH75557Medicare UPIN