Provider Demographics
NPI:1346205143
Name:CHARNEY, DAVID JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:CHARNEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3076 EAGLE VALLEY RD.
Mailing Address - Street 2:
Mailing Address - City:MILL HALL
Mailing Address - State:PA
Mailing Address - Zip Code:17751-1626
Mailing Address - Country:US
Mailing Address - Phone:570-726-2000
Mailing Address - Fax:570-726-8012
Practice Address - Street 1:3076 EAGLE VALLEY RD.
Practice Address - Street 2:
Practice Address - City:MILL HALL
Practice Address - State:PA
Practice Address - Zip Code:17751-1626
Practice Address - Country:US
Practice Address - Phone:570-726-2000
Practice Address - Fax:570-726-8012
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009076111N00000X
PAAJ008899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101092313-0001Medicaid
1643145OtherBCBS
PA101092313-0001Medicaid