MEDICARE: ROBERT S CHERNEY PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	3857	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W03864	OTHER	MA	BC/BS
2	724191	OTHER	MA	TUFTS

General Provider Information

NPI Number	:	1104910371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT S CHERNEY PHD

Provider Business Mailing Address
First Line	:	1195 WASHINGTON ST
Second Line	:
City	:	HOLLISTON
State	:	MA
Zip	:	01746-2259
Country	:	US
Telephone Number	:	508-429-1834
Fax Number	:

Provider Business Practice Location Address
First Line	:	1195 WASHINGTON ST
Second Line	:
City	:	HOLLISTON
State	:	MA
Zip	:	01746-2259
Country	:	US
Telephone Number	:	508-429-1834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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Directions to “ ROBERT S CHERNEY PHD” Practice Location

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