Provider Demographics
NPI:1073573416
Name:CHERCHIA, MICHAEL JAMES (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:CHERCHIA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566
Mailing Address - Country:US
Mailing Address - Phone:914-737-5416
Mailing Address - Fax:914-737-5935
Practice Address - Street 1:939 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566
Practice Address - Country:US
Practice Address - Phone:914-737-5416
Practice Address - Fax:914-737-5935
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0042161213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
W5704OtherOXFORD
27386OtherWELLCARE
756135OtherUNITED HEALTHCARE
960264OtherMVP
NYP46031OtherBLUE CROSS
133647666002OtherCIGNA
NY01082833Medicaid
0002169OtherGHI
002035OtherAMERIHEALTH
2702348OtherEVERCARE
2C3724OtherHEALTHNET
P46031Medicare ID - Type Unspecified
002035OtherAMERIHEALTH
W5704OtherOXFORD