Provider Demographics
NPI:1124688080
Name:DARJ, ELNAZ (RPH)
Entity type:Individual
Prefix:
First Name:ELNAZ
Middle Name:
Last Name:DARJ
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 1:8401 CONNECTICUT AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5816
Mailing Address - Country:US
Mailing Address - Phone:301-986-5354
Mailing Address - Fax:301-986-4962
Practice Address - Street 1:8401 CONNECTICUT AVE STE 110
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5816
Practice Address - Country:US
Practice Address - Phone:301-986-5354
Practice Address - Fax:301-986-4962
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17556183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist