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General NPI Number Information
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NPI Number | 1306541610
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Entity Type | Individual
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Provider Name | LANCE JACOB CHERVINSKY DDS
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Gender | Male
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1037 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10022-4024
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Country | US
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Telephone | 212-317-5959
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Fax |
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Provider Business Mailing Address
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Address Line | 1037 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10022-4024
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Country | US
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Telephone | 332-330-3538
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 064172
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License Number State | NY
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