Provider Demographics
NPI:1134332133
Name:CHERTOK, HALLIE FELYSE (NPF)
Entity type:Individual
Prefix:MS
First Name:HALLIE
Middle Name:FELYSE
Last Name:CHERTOK
Suffix:
Gender:F
Credentials:NPF
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 8397
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-8397
Mailing Address - Country:US
Mailing Address - Phone:718-784-2240
Mailing Address - Fax:
Practice Address - Street 1:2101 41ST AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4801
Practice Address - Country:US
Practice Address - Phone:718-784-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY905229-01163W00000X
NYF352745-01363LF0000X
CA18299363L00000X, 363LF0000X
CANPF18299363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily