Provider Demographics
NPI:1902055304
Name:DONALD M CHERVENAK MD FACOG PA
Entity Type:Organization
Organization Name:DONALD M CHERVENAK MD FACOG PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHERVENAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-822-8495
Mailing Address - Street 1:15 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1346
Mailing Address - Country:US
Mailing Address - Phone:973-822-3879
Mailing Address - Fax:
Practice Address - Street 1:15 JAMES ST
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1346
Practice Address - Country:US
Practice Address - Phone:973-822-3879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty