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Clara Jean Chudow

Radiology

Allopathic & Osteopathic Physicians

100 N Academy Ave, Danville, PA 17822-5210

PECOS Enrollment

This provider is enrolled in PECOS as CLARA CHUDOW.

Based on the most recent information from CMS, provider Clara Jean Chudow is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1053300228
Provider Type
Individual
Full Name
Chudow, Clara Jean
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
10/19/2005
Last Updated
6/24/2020

Contact Information

Practice Location

100 N Academy Ave, Danville, PA 17822-5210

(570) 271-6301

(570) 271-5976

Mailing Location

100 N Academy Ave, Danville, PA 17822-4903

(570) 271-6144

(570) 271-6578

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License MD432692 Pennsylvania

Provider Identifiers

ID	Description	Issuer
ID 00944858	Description Medicaid	Issuer Unlisted New York

Clara Jean Chudow

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Pitzen, Joshua Nicholas

Triffo, William Jeffrey

Dunne, Anne P.

Moshiri, Sara T.

Patel, Rasila P.

Albakri, Lythe

Rosica, Dillenia

Malone, William J.

Rogers, Kenneth J.

Geisinger Clinic