Healthcare Provider Details

I. General information

NPI: 1588967285
Provider Name (Legal Business Name): BRAD M CHERNOCK MD, PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2010
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROBERT WOOD JOHNSON PL DEPT OF SURGERY
NEW BRUNSWICK NJ
08901
US

IV. Provider business mailing address

125 PATERSON ST SUITE 6300 - DIV OF ACUTE CARE SURGERY
NEW BRUNSWICK NJ
08901-4766
US

V. Phone/Fax

Practice location:
  • Phone: 732-828-3000
  • Fax:
Mailing address:
  • Phone: 732-235-7766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD494481
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA12108600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: