Basic Information
Provider Information
NPI: 1992970164
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHERNOBELSKY
FirstName: OKSANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O. BOX 550
Address2: 2 CATHARINE STREET, EAST MANHATTAN ANESTHESIA PARTNERS,
City: POUGHKEEPSIE
State: NY
PostalCode: 12602
CountryCode: US
TelephoneNumber: 8668688415
FaxNumber: 8457902675
Practice Location
Address1: 310 E. 14TH STREET
Address2: NY EYE & EAR INFIRMARY
City: NEW YORK
State: NY
PostalCode: 10003
CountryCode: US
TelephoneNumber: 2129794000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/28/2008
LastUpdateDate: 12/04/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X251676-1NYY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
0314036505NY MEDICAID


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