MEDICARE: ANIE A CHERIAN D.P.M P.C.

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	213ES0000X	Sports Medicine Podiatrist	N005013	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134194426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANIE A CHERIAN D.P.M P.C.

Provider Business Mailing Address
First Line	:	PO BOX 20280
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10302-0280
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1775 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3907
Country	:	US
Telephone Number	:	917-816-5078
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPRIETER
Name	:	ANIE A CHERIAN
Credential	:	D.P.M.
Telephone Number	:	917-816-5078

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	06/25/2008

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