Provider Demographics
NPI:1497392393
Name:SCHANKER, INEZ CHESHIRE BUCHKO
Entity Type:Individual
Prefix:
First Name:INEZ CHESHIRE
Middle Name:BUCHKO
Last Name:SCHANKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CHESTNUT ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-3488
Mailing Address - Country:US
Mailing Address - Phone:317-331-5801
Mailing Address - Fax:
Practice Address - Street 1:333 WYMAN ST STE 100
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1272
Practice Address - Country:US
Practice Address - Phone:317-331-5801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical