Provider Demographics
NPI:1073649851
Name:CHERKASHENKO, EDUARD (LAC)
Entity Type:Individual
Prefix:
First Name:EDUARD
Middle Name:
Last Name:CHERKASHENKO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3099 CONEY ISLAND AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6305
Mailing Address - Country:US
Mailing Address - Phone:718-616-0066
Mailing Address - Fax:718-616-0086
Practice Address - Street 1:3099 CONEY ISLAND AVE FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6305
Practice Address - Country:US
Practice Address - Phone:718-616-0066
Practice Address - Fax:718-616-0086
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003034171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist