Provider Demographics
NPI:1619619038
Name:CHROMY-BABB, JEN-ALICE
Entity Type:Individual
Prefix:
First Name:JEN-ALICE
Middle Name:
Last Name:CHROMY-BABB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEN-ALICE
Other - Middle Name:
Other - Last Name:CHROMY-BABB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:81 MEADOWBROOKE LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1641
Mailing Address - Country:US
Mailing Address - Phone:508-641-6857
Mailing Address - Fax:781-281-8276
Practice Address - Street 1:81 MEADOWBROOKE LN
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1641
Practice Address - Country:US
Practice Address - Phone:508-641-6857
Practice Address - Fax:781-281-8276
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor