Provider Demographics
NPI:1457466880
Name:DRS CHERNIN & EGAN INC
Entity Type:Organization
Organization Name:DRS CHERNIN & EGAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHERNIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:440-951-9669
Mailing Address - Street 1:35104 EUCLID AVE.
Mailing Address - Street 2:STE. 110
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4519
Mailing Address - Country:US
Mailing Address - Phone:440-951-9669
Mailing Address - Fax:440-951-8117
Practice Address - Street 1:6505 ROCKSIDE RD
Practice Address - Street 2:STE. 120
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2342
Practice Address - Country:US
Practice Address - Phone:216-524-1900
Practice Address - Fax:216-524-9823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9341862Medicare PIN
OH9341861Medicare PIN