Provider Demographics
NPI:1972752962
Name:WILLIAM J. CHERNACK, M.D.,P.A.
Entity Type:Organization
Organization Name:WILLIAM J. CHERNACK, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOK KEEPER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SNEDAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-538-7271
Mailing Address - Street 1:28 FRANKLIN PL
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5378
Mailing Address - Country:US
Mailing Address - Phone:973-538-7271
Mailing Address - Fax:
Practice Address - Street 1:28 FRANKLIN PL
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5378
Practice Address - Country:US
Practice Address - Phone:973-538-7271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03168500207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ165592Medicare PIN