Provider Demographics
NPI:1235806571
Name:BERNADY-CHOCHLA, BEATA
Entity Type:Individual
Prefix:MRS
First Name:BEATA
Middle Name:
Last Name:BERNADY-CHOCHLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23125 GREATER MACK AVENUE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080
Mailing Address - Country:US
Mailing Address - Phone:313-265-7225
Mailing Address - Fax:248-306-8785
Practice Address - Street 1:23125 GREATER MACK AVE UNIT 5
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-7701
Practice Address - Country:US
Practice Address - Phone:313-265-7225
Practice Address - Fax:248-306-8785
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide