Provider Demographics
NPI:1386203602
Name:SHROFF, CHANDNI (MS)
Entity Type:Individual
Prefix:
First Name:CHANDNI
Middle Name:
Last Name:SHROFF
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 SUTHERLAND RD # 2
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-7302
Mailing Address - Country:US
Mailing Address - Phone:919-757-1228
Mailing Address - Fax:
Practice Address - Street 1:69 ALLEGHANY ST
Practice Address - Street 2:
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120-3336
Practice Address - Country:US
Practice Address - Phone:617-254-0964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical