Basic Information
| Provider Information | |||||||||
| NPI: | 1740265669 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHIU | ||||||||
| FirstName: | LOLITA | ||||||||
| MiddleName: | EVANGELISTA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 858 | ||||||||
| Address2: | MC A410 | ||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170330858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431455 | ||||||||
| FaxNumber: | 7175314633 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 CARLISLE STREET | ||||||||
| Address2: | ALLE-KISKI MEDICAL CENTER | ||||||||
| City: | NATRONA HEIGHTS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150651152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242245100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2005 | ||||||||
| LastUpdateDate: | 03/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | MD419960 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 0019084320004 | 05 | PA | MEDICAID | 2389393 | 05 | OH | MEDICAID |