Provider Demographics
NPI:1598785206
Name:CHERNICK, NEIL (MSPT,OCS,CSCS)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:CHERNICK
Suffix:
Gender:M
Credentials:MSPT,OCS,CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-0266
Mailing Address - Country:US
Mailing Address - Phone:845-615-1585
Mailing Address - Fax:845-615-1576
Practice Address - Street 1:530 MAIN ST
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-1843
Practice Address - Country:US
Practice Address - Phone:845-615-1585
Practice Address - Fax:845-615-1576
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7266174400000X
NY024707225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT650000811Medicare ID - Type Unspecified