Provider Demographics
NPI:1275597874
Name:CHERNEY, JAY K (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:K
Last Name:CHERNEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 FOX HOLLOW ROAD
Mailing Address - Street 2:
Mailing Address - City:GWYNEDD VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19437-0405
Mailing Address - Country:US
Mailing Address - Phone:215-628-0177
Mailing Address - Fax:215-646-1037
Practice Address - Street 1:709 FOX HOLLOW ROAD
Practice Address - Street 2:
Practice Address - City:GWYNEDD VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19437-0405
Practice Address - Country:US
Practice Address - Phone:215-628-0177
Practice Address - Fax:215-646-1037
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-4234-L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA122760Medicare ID - Type Unspecified