Healthcare Provider Details

I. General information

NPI: 1275688665
Provider Name (Legal Business Name): DAVID CHERNOCK, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 LOCUST ST
NORTHAMPTON MA
01060-2052
US

IV. Provider business mailing address

PO BOX 1177
NORTHAMPTON MA
01061-1177
US

V. Phone/Fax

Practice location:
  • Phone: 413-582-2105
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DIANE QUINN
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 413-586-8443