Healthcare Provider Details

I. General information

NPI: 1386366201
Provider Name (Legal Business Name): HEATHER MARIE CHERNOSKY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 09/16/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 ROUTE 70
LAKEWOOD NJ
08701-5949
US

IV. Provider business mailing address

2509 SPRUCE ST
POINT PLEASANT BORO NJ
08742-3669
US

V. Phone/Fax

Practice location:
  • Phone: 732-370-0444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: