Provider Demographics
NPI:1144903873
Name:CHOMA, CHRISTINA LAUREN (RDN, LDN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LAUREN
Last Name:CHOMA
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 CHAPMAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5411
Mailing Address - Country:US
Mailing Address - Phone:302-668-4697
Mailing Address - Fax:
Practice Address - Street 1:258 CHAPMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5411
Practice Address - Country:US
Practice Address - Phone:302-283-7164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDN-0010929133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered