Provider Demographics
NPI:1528785326
Name:CHODON, TASHI (FNP-BC)
Entity type:Individual
Prefix:
First Name:TASHI
Middle Name:
Last Name:CHODON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 W 114TH ST FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1710
Mailing Address - Country:US
Mailing Address - Phone:212-659-8552
Mailing Address - Fax:212-523-7124
Practice Address - Street 1:419 W 114TH ST FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1710
Practice Address - Country:US
Practice Address - Phone:212-659-8552
Practice Address - Fax:212-523-7124
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF349476363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily