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NPI Code Detail

MEDICARE: MR. ALLEN BRADLEY CHERNENKOFF R.PH.

MEDICARE: MR. ALLEN BRADLEY CHERNENKOFF R.PH.
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
1183500000XPharmacist065160NY

General Provider Information

NPI Number : 1962962738
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALLEN BRADLEY CHERNENKOFF R.PH.
Provider Business Mailing Address
First Line : 12333 83RD AVE APT LB
Second Line :
City : KEW GARDENS
State : NY
Zip : 11415-3449
Country : US
Telephone Number : 917-670-4717
Fax Number :
Provider Business Practice Location Address
First Line : 454 5TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-4003
Country : US
Telephone Number : 718-768-0600
Fax Number : 718-832-2912
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2019
Last Update Date : 03/20/2019

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