Provider Demographics
NPI:1194862904
Name:ROCKLAND ENDOCRINOLOGY, PC
Entity Type:Organization
Organization Name:ROCKLAND ENDOCRINOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERNOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-620-0220
Mailing Address - Street 1:275 N MIDDLETOWN RD
Mailing Address - Street 2:SUITE 1-H
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1188
Mailing Address - Country:US
Mailing Address - Phone:845-620-0220
Mailing Address - Fax:845-620-0550
Practice Address - Street 1:275 N MIDDLETOWN RD
Practice Address - Street 2:SUITE 1-H
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1188
Practice Address - Country:US
Practice Address - Phone:845-620-0220
Practice Address - Fax:845-620-0550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203600302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization