Provider Demographics
NPI:1396745568
Name:CHITTALIA, ALIASGAR (MD)
Entity type:Individual
Prefix:
First Name:ALIASGAR
Middle Name:
Last Name:CHITTALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:35 S MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN TOP
Practice Address - State:PA
Practice Address - Zip Code:18707-1122
Practice Address - Country:US
Practice Address - Phone:570-474-5978
Practice Address - Fax:570-474-5485
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426803207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02776OtherFIRST PRIORITY HEALTH
PA434707OtherHEALTH AMERICA
PA50054436OtherKEYSTONE CAPITAL BC
PA001765027OtherHIGHMARK BS
3960889OtherAETNA HMO
7924769OtherAETNA PPO
PA1014558950003Medicaid
PA20048214OtherAMERIHEALTH MERCY
5651874OtherFIRST HEALTH
392472OtherAETNA HMO PCP
PA95925OtherGEISINGER
7924769OtherAETNA PPO
PA095854WBDMedicare PIN