Provider Demographics
NPI:1891723953
Name:CHIMAHOSKY, JEFFREY (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:CHIMAHOSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 W MARKET ST
Mailing Address - Street 2:PO BOX 1263
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-2141
Mailing Address - Country:US
Mailing Address - Phone:570-622-1910
Mailing Address - Fax:570-622-5030
Practice Address - Street 1:1720 W MARKET ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-2141
Practice Address - Country:US
Practice Address - Phone:570-622-1910
Practice Address - Fax:570-622-5030
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013721207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI60474OtherHEALTH AMERICA
PA1879830OtherHIGHMARK BLUE SHIELD
PA50065175OtherKEYSTONE HEALTH PLANS
PA50065175OtherCAPITAL BLUE CROSS
PA102014 S154OtherGEISINGER HEALTH PLANS
PA50065175OtherKEYSTONE HEALTH PLANS