Provider Demographics
NPI:1457615205
Name:CHERNOFF, ALEXIS (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:CHERNOFF
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6924 66TH PL
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-6542
Mailing Address - Country:US
Mailing Address - Phone:917-572-3517
Mailing Address - Fax:
Practice Address - Street 1:6924 66TH PL
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-6542
Practice Address - Country:US
Practice Address - Phone:917-572-3517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000748103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst