Provider Demographics
NPI:1679746028
Name:CHODNICKI, MARIAN DENISE (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:DENISE
Last Name:CHODNICKI
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 1:24717 PEALIQUOR RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-2304
Mailing Address - Country:US
Mailing Address - Phone:410-479-1584
Mailing Address - Fax:
Practice Address - Street 1:24717 PEALIQUOR RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-2304
Practice Address - Country:US
Practice Address - Phone:410-479-1584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002342183500000X
MD10265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist