Provider Demographics
NPI:1912911918
Name:CHERNYAVSKY, ALEX (DC)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:
Last Name:CHERNYAVSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:A.EX
Other - Middle Name:
Other - Last Name:CHERNYAVSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1053 GRAND AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3022
Mailing Address - Country:US
Mailing Address - Phone:651-292-9247
Mailing Address - Fax:
Practice Address - Street 1:1919 UNIVERSITY AVE W
Practice Address - Street 2:SUITE 105
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3453
Practice Address - Country:US
Practice Address - Phone:651-644-7207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU94265Medicare UPIN