Provider Demographics
NPI:1831455336
Name:CHERNYSHOVA, NATALIA (MSOTR/L)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:CHERNYSHOVA
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BYBERRY RD
Mailing Address - Street 2:B15
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-1947
Mailing Address - Country:US
Mailing Address - Phone:267-262-2279
Mailing Address - Fax:
Practice Address - Street 1:301 BYBERRY RD
Practice Address - Street 2:B15
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-1947
Practice Address - Country:US
Practice Address - Phone:267-262-2279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology