Provider Demographics
NPI:1598773442
Name:OPALACK, CHERYL A (DO)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:OPALACK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:154 EXTON SQUARE MALL
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2440
Mailing Address - Country:US
Mailing Address - Phone:484-421-1669
Mailing Address - Fax:610-903-1084
Practice Address - Street 1:32 SAPLING DRIVE
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348
Practice Address - Country:US
Practice Address - Phone:610-388-3190
Practice Address - Fax:610-388-3191
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS003388L2083X0100X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice