Provider Demographics
NPI:1346563434
Name:ELFADEL, CHAZA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHAZA
Middle Name:
Last Name:ELFADEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 SASSINORO BLVD
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-5152
Mailing Address - Country:US
Mailing Address - Phone:914-736-2316
Mailing Address - Fax:
Practice Address - Street 1:202 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-6106
Practice Address - Country:US
Practice Address - Phone:914-762-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053212183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist