Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | R189564 | MD |
NPI | 1013334218 |
---|---|
Provider Name | Danielle Cheplowitz |
First Address | Chester, MD 21619-2649 |
Second Address | Pasadena, MD 21122-4414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2014 |
Last Update Date | 11/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
350068ZAR | MEDICARE ID (01) | MD |