Basic Information
| Provider Information | |||||||||
| NPI: | 1407016900 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TSCHERNYAVSKY | ||||||||
| FirstName: | SYLVIA | ||||||||
| MiddleName: | JULIE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1823 COLLEGE AVE | ||||||||
| Address2: | |||||||||
| City: | MANHATTAN | ||||||||
| State: | KS | ||||||||
| PostalCode: | 665023381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7857762800 | ||||||||
| FaxNumber: | 7855654754 | ||||||||
| Practice Location | |||||||||
| Address1: | 1823 COLLEGE AVE | ||||||||
| Address2: | |||||||||
| City: | MANHATTAN | ||||||||
| State: | KS | ||||||||
| PostalCode: | 665023381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7857762800 | ||||||||
| FaxNumber: | 7855654754 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2008 | ||||||||
| LastUpdateDate: | 11/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 139062 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 28598 | NE | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | Q1042 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PE0004X | 251091 | NY | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207P00000X | 04-35269 | KS | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 201088610B | 05 | KS | MEDICAID | 068002361 | 01 | KS | MEDICARE PTAN | OTHER |