1235614942 NPI number — KATHLEEN MARGARET CHOPRA AU.D.

Table of content: KATHLEEN MARGARET CHOPRA AU.D. (NPI 1235614942)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235614942 NPI number — KATHLEEN MARGARET CHOPRA AU.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHOPRA
Provider First Name:
KATHLEEN
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
AU.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BURNS
Provider Other First Name:
KATHLEEN
Provider Other Middle Name:
MARGARET
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235614942
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11300 ROCKVILLE PIKE STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20852-3042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-477-1010
Provider Business Mailing Address Fax Number:
240-477-1012

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11300 ROCKVILLE PIKE STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20852-3042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-477-1010
Provider Business Practice Location Address Fax Number:
240-477-1012
Provider Enumeration Date:
09/27/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  01450 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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