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Individual

DR. DEEPA KUCHELAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 887-2508
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD427160
PA
207RP1001X
Pulmonary Disease Physician
Primary
MD427160
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02678779
NY
05
1013438990001
PA
01
CC9269
RR MEDICARE GROUP
PA
01
GU039812
MEDICARE GROUP
PA
01
P00240756
RR MEDICARE PIN
PA
Enumeration date
03/14/2006
Last updated
03/19/2021
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