Healthcare Provider Details

I. General information

NPI: 1184533218
Provider Name (Legal Business Name): CHOSIDERA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4229 LAFAYETTE CENTER DR STE 1175
CHANTILLY VA
20151-1264
US

IV. Provider business mailing address

4229 LAFAYETTE CENTER DR STE 1175
CHANTILLY VA
20151-1264
US

V. Phone/Fax

Practice location:
  • Phone: 571-367-2617
  • Fax:
Mailing address:
  • Phone: 571-367-2617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: REBECCA ESEONU-CHUKWU
Title or Position: DIRECTOR
Credential:
Phone: 571-367-2617