Provider Demographics
NPI:1144249350
Name:DEPERSIA, CHERNOFF & OCASIO, PC
Entity type:Organization
Organization Name:DEPERSIA, CHERNOFF & OCASIO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHERNOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-845-0664
Mailing Address - Street 1:935 KINGS HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08086-2238
Mailing Address - Country:US
Mailing Address - Phone:856-845-0664
Mailing Address - Fax:856-845-7602
Practice Address - Street 1:935 KINGS HWY STE 100
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08086-2238
Practice Address - Country:US
Practice Address - Phone:856-845-0664
Practice Address - Fax:856-845-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ100392VA6Medicare ID - Type Unspecified