Basic Information
| Provider Information | |||||||||
| NPI: | 1396117420 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHECHAK | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | STEPHEN | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 331 FABER ST | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152142136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123220636 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1719 UNION AVE STE A | ||||||||
| Address2: | |||||||||
| City: | NATRONA HEIGHTS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150652146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242262128 | ||||||||
| FaxNumber: | 7242262498 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2015 | ||||||||
| LastUpdateDate: | 10/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | SP015349 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.