Healthcare Provider Details

I. General information

NPI: 1679936751
Provider Name (Legal Business Name): REBECCA CHORNOCK M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 WILLOW OAKS CORPORATE DR STE 350
FAIRFAX VA
22031-4527
US

IV. Provider business mailing address

110 IRVING ST NW DEPT OF OBSTETRICS AND GYNECOLOGY
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-0920
  • Fax: 571-472-0921
Mailing address:
  • Phone: 202-877-8035
  • Fax: 202-877-5435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number0101268902
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: