Provider Demographics
NPI:1326032376
Name:HOFBERG, NATASHA CHASNOVITZ (CFNP)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:CHASNOVITZ
Last Name:HOFBERG
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:MARIE
Other - Last Name:CHASNOVITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFNP
Mailing Address - Street 1:555 HERNDON PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-5276
Mailing Address - Country:US
Mailing Address - Phone:703-481-1505
Mailing Address - Fax:703-742-8793
Practice Address - Street 1:555 HERNDON PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5276
Practice Address - Country:US
Practice Address - Phone:703-481-1505
Practice Address - Fax:703-742-8793
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA014999F32Medicare ID - Type Unspecified
Q24851Medicare UPIN