Basic Information
| Provider Information | |||||||||
| NPI: | 1396745568 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHITTALIA | ||||||||
| FirstName: | ALIASGAR | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 N ACADEMY AVE | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178224903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702716144 | ||||||||
| FaxNumber: | 5702716578 | ||||||||
| Practice Location | |||||||||
| Address1: | 35 S MOUNTAIN BLVD | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN TOP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187071122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704745978 | ||||||||
| FaxNumber: | 5704745485 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2005 | ||||||||
| LastUpdateDate: | 06/11/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD426803 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 02776 | 01 | PA | FIRST PRIORITY HEALTH | OTHER | 434707 | 01 | PA | HEALTH AMERICA | OTHER | 50054436 | 01 | PA | KEYSTONE CAPITAL BC | OTHER | 001765027 | 01 | PA | HIGHMARK BS | OTHER | 3960889 | 01 | AETNA HMO | OTHER | 7924769 | 01 | AETNA PPO | OTHER | 1014558950003 | 05 | PA | MEDICAID | 20048214 | 01 | PA | AMERIHEALTH MERCY | OTHER | 5651874 | 01 | FIRST HEALTH | OTHER | 392472 | 01 | AETNA HMO PCP | OTHER | 95925 | 01 | PA | GEISINGER | OTHER |