Provider Demographics
NPI:1528194354
Name:CHERIAN, PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:CHERIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82-47 258TH STREET
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11004
Mailing Address - Country:US
Mailing Address - Phone:718-831-1653
Mailing Address - Fax:
Practice Address - Street 1:111 W CENTRE ST
Practice Address - Street 2:APARTMENT 207
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4569
Practice Address - Country:US
Practice Address - Phone:443-224-2961
Practice Address - Fax:443-224-2961
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program