Basic Information
Provider Information
NPI: 1982962833
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHHIPA
FirstName: IRFAN
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 833 CHESTNUT ST STE 520
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191074430
CountryCode: US
TelephoneNumber: 6096777003
FaxNumber:  
Practice Location
Address1: 2500 ENGLISH CREEK AVE
Address2: BUILDING 1300
City: EGG HARBOR TOWNSHIP
State: NJ
PostalCode: 082345549
CountryCode: US
TelephoneNumber: 6096776060
FaxNumber: 6096776061
Other Information
ProviderEnumerationDate: 04/29/2012
LastUpdateDate: 11/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X25MA09146500NJN Allopathic & Osteopathic PhysiciansFamily Medicine 
207QS0010X25MA09146500NJY Allopathic & Osteopathic PhysiciansFamily MedicineSports Medicine

No ID Information.


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