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General NPI Number Information
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NPI Number | 1750801080
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Entity Type | Individual
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Provider Name | JEFFERY ALAN CHODROW
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Gender | Male
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1282 TWELVE ACRE RD
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City | MONETA
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State | VA
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Zip | 24121-1779
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Country | US
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Telephone | 540-330-5252
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Fax |
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Provider Business Mailing Address
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Address Line | 1282 TWELVE ACRE RD
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City | MONETA
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State | VA
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Zip | 24121-1779
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Country | US
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Telephone | 540-330-5252
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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 | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 0202207482
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License Number State | VA
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