Chacko, Lisa
Chacko, Lisa is an individual health care provider with primary practice located at 2966 Street Rd , Bensalem PA 19020-2604. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Chacko, Lisa can be contacted via phone (215) 639-2639.Contact Information
Primary practice address
2966 Street Rd
Bensalem PA 19020-2604
Phone: (215) 639-2639
Fax: (215) 929-2464
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT0176278 | Pennsylvania |
Profile Details
| NPI number | 1588677918 |
|---|---|
| LBN Legal business name | Chacko, Lisa |
| Credentials | LPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2006 |
| Last updated | Feb 2nd, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588677918 | NPPES |
| Pennsylvania | Other | 30052556 | KEYSTONE MERCY |
| Pennsylvania | MEDICAID | 1023356770001 | KEYSTONE MERCY |
| Pennsylvania | Other | 2579694000 | KEYSTONE MERCY |
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