Provider Demographics
NPI:1164897419
Name:FOGEL, CHANA ESTHER (MGC)
Entity Type:Individual
Prefix:
First Name:CHANA
Middle Name:ESTHER
Last Name:FOGEL
Suffix:
Gender:F
Credentials:MGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3312 GREENVALE RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4511
Mailing Address - Country:US
Mailing Address - Phone:410-929-1613
Mailing Address - Fax:
Practice Address - Street 1:3312 GREENVALE RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4511
Practice Address - Country:US
Practice Address - Phone:410-929-1613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS