Healthcare Provider Details

I. General information

NPI: 1568677326
Provider Name (Legal Business Name): ELIZABETH GWEN CHOMA CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH G SALTZSTEIN CPNP

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 21ST ST NW
WASHINGTON DC
20052-0028
US

IV. Provider business mailing address

PO BOX 17334
BALTIMORE MD
21297-1334
US

V. Phone/Fax

Practice location:
  • Phone: 202-994-5300
  • Fax:
Mailing address:
  • Phone: 703-443-6717
  • Fax: 703-443-8643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP009249
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024167904
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: