Provider Demographics
NPI:1710912944
Name:CHODOFF, MARK E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:CHODOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:76 CARLON DR STE A
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2377
Mailing Address - Country:US
Mailing Address - Phone:413-584-4637
Mailing Address - Fax:413-584-4787
Practice Address - Street 1:76 CARLON DR STE A
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2377
Practice Address - Country:US
Practice Address - Phone:413-584-4637
Practice Address - Fax:413-584-4787
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY113138208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABB9421Medicare PIN
MAB72512Medicare UPIN