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General NPI Number Information
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NPI Number | 1326628397
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Entity Type | Individual
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Provider Name | MARK ALEXANDER CHAUSOVSKY PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 5315 HENNEMAN DR
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City | NORFOLK
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State | VA
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Zip | 23513-2401
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Country | US
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Telephone | 757-853-0048
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Fax |
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Provider Business Mailing Address
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Address Line | 3577 CROFTS PRIDE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-8516
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Country | US
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Telephone | 757-348-0985
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202213686
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License Number State | VA
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