Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 003399 | NY |
Y | 222Z00000X | Podiatrist | 003399 | NY |
NPI | 1063507960 |
---|---|
Provider Name | Stephen B. Chernick |
First Address | Hempstead, NY 11550-3702 |
Second Address | Forest Hills, NY 11375-7417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 10/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00763786 | (05) | NY |
T32084 | (02) | NY |