Provider Demographics
NPI:1245433135
Name:STUART B. CHERNEY, M.D., P.C.
Entity Type:Organization
Organization Name:STUART B. CHERNEY, M.D., P.C.
Other - Org Name:ALL-SPORT ORTHOPAEDIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-361-7867
Mailing Address - Street 1:290 E MAIN ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2916
Mailing Address - Country:US
Mailing Address - Phone:631-361-7867
Mailing Address - Fax:
Practice Address - Street 1:290 E MAIN ST
Practice Address - Street 2:SUITE 700
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2916
Practice Address - Country:US
Practice Address - Phone:631-361-7867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138328207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100000719Medicare UPIN
NY1245433135Medicare PIN