Provider Demographics
NPI:1427651991
Name:CHOUDHARY, LIZA
Entity type:Individual
Prefix:DR
First Name:LIZA
Middle Name:
Last Name:CHOUDHARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 LONGBRANCH DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-2518
Mailing Address - Country:US
Mailing Address - Phone:202-316-6101
Mailing Address - Fax:
Practice Address - Street 1:3480 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3104
Practice Address - Country:US
Practice Address - Phone:703-931-1333
Practice Address - Fax:703-933-6190
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist