1871753111 NPI number — MRS. JENNIFER RENEE CHERNEY L.P.C.

Table of content: MRS. JENNIFER RENEE CHERNEY L.P.C. (NPI 1871753111)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871753111 NPI number — MRS. JENNIFER RENEE CHERNEY L.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHERNEY
Provider First Name:
JENNIFER
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L.P.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PACIOREK
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1871753111
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24178 NOREEN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH OLMSTED
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44070-1044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-716-0693
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
230 S COURT ST STE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEDINA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44256-2259
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-723-7977
Provider Business Practice Location Address Fax Number:
330-725-5177
Provider Enumeration Date:
06/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  C0008330 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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