Provider Demographics
NPI:1801165238
Name:HERSHKOP, CHANA R (PHARMD, BCGP)
Entity type:Individual
Prefix:DR
First Name:CHANA
Middle Name:R
Last Name:HERSHKOP
Suffix:
Gender:F
Credentials:PHARMD, BCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WILTSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3636
Mailing Address - Country:US
Mailing Address - Phone:917-650-1284
Mailing Address - Fax:
Practice Address - Street 1:1 WILTSHIRE RD
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3636
Practice Address - Country:US
Practice Address - Phone:917-650-1284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4492851835G0303X
NY0504811835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric