MEDICARE: MRS. EMLY S CHERNOFF SC

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	171M00000X	Case Manager/Care Coordinator	15425	NY

General Provider Information

NPI Number	:	1336426170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMLY S CHERNOFF SC

Provider Business Mailing Address
First Line	:	2102 NEW YORK AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5424
Country	:	US
Telephone Number	:	718-253-4908
Fax Number	:

Provider Business Practice Location Address
First Line	:	2102 NEW YORK AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5424
Country	:	US
Telephone Number	:	718-253-4908
Fax Number	:

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

Provider Enumeration Date	:	11/08/2011
Last Update Date	:	11/08/2011

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