Healthcare Provider Details

I. General information

NPI: 1548294739
Provider Name (Legal Business Name): CHERYL ANN DENICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 PARK DR STE 101
HARRISBURG PA
17110-9303
US

IV. Provider business mailing address

ONE MEDICAL CENTER BLVD
UPLAND PA
19013
US

V. Phone/Fax

Practice location:
  • Phone: 717-686-9842
  • Fax: 844-803-8108
Mailing address:
  • Phone: 610-447-6370
  • Fax: 610-447-6373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101251886
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: