Provider Demographics
NPI:1073977450
Name:CHOMICKI, GLORIA CHIOMA (NP)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:CHIOMA
Last Name:CHOMICKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 HORSESHOE CURVE DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-7718
Mailing Address - Country:US
Mailing Address - Phone:267-323-9490
Mailing Address - Fax:
Practice Address - Street 1:713 HORSESHOE CURVE DR
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-7718
Practice Address - Country:US
Practice Address - Phone:267-323-9490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015408363LF0000X
NJ26NJ00575900364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily