MEDICARE: LEONID CHERNYAK DO

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	247979-1	NY
2	208VP0014X	Interventional Pain Medicine Physician	247979	NY

General Provider Information

NPI Number	:	1457507469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONID CHERNYAK DO

Provider Business Mailing Address
First Line	:	2277-83 CONEY ISLAND AVE
Second Line	:	SUITE 2A
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3337
Country	:	US
Telephone Number	:	718-998-9890
Fax Number	:	718-998-9891

Provider Business Practice Location Address
First Line	:	2277-83 CONEY ISLAND AVE
Second Line	:	SUITE 2A
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3337
Country	:	US
Telephone Number	:	718-998-9890
Fax Number	:	718-998-9891

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

Provider Enumeration Date	:	08/09/2008
Last Update Date	:	04/13/2015

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