Provider Demographics
NPI:1336250778
Name:S. CHAPA, M.D., INC
Entity Type:Organization
Organization Name:S. CHAPA, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUKUMAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-849-5151
Mailing Address - Street 1:240 ALLEGHENY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-2324
Mailing Address - Country:US
Mailing Address - Phone:814-849-5151
Mailing Address - Fax:814-849-9624
Practice Address - Street 1:240 ALLEGHENY BLVD STE A
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-2324
Practice Address - Country:US
Practice Address - Phone:814-849-5151
Practice Address - Fax:814-849-9624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038943L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008219620002Medicaid
PA022179Medicare PIN