Individual
DR. EUGENE J CHIAVACCI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
730 S MAIN ST, OLD FORGE, PA 18518-1459
(570) 457-3300
(570) 457-4878
Mailing address
730 S MAIN ST, OLD FORGE, PA 18518-1459
(570) 457-3300
(570) 457-4878
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD027185E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00920915
—
PA
Enumeration date
10/16/2005
Last updated
07/08/2007
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