Provider Demographics
NPI:1548294739
Name:DENICK, CHERYL ANN (MD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANN
Last Name:DENICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19013
Mailing Address - Country:US
Mailing Address - Phone:610-447-6370
Mailing Address - Fax:610-447-6373
Practice Address - Street 1:2401 PARK DR STE 101
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9303
Practice Address - Country:US
Practice Address - Phone:717-686-9842
Practice Address - Fax:844-803-8108
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251886207P00000X
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01863869-01OtherAMERICHOICE
PA20045115OtherAMERIHEALTH MERCY
PA810300818OtherPHCS
PA0533292000OtherKEYSTONE IBC
PA07645OtherHEALTH PARTNERS
PA1974042OtherFIRST HEALTH
PA0018638690003Medicaid
PA01863869-02OtherAMERICHOICE
PA698314OtherHIGHMARK BLUE SHIELD
PA0018638690002Medicaid
PA1090988OtherKEYSTONE MERCY
PA7887164OtherCIGNA
PA01863869-03OtherAMERICHOICE
PA0018638690004Medicaid
PA698314OtherPERSONAL CHOICE
PA452729OtherAETNA CONTRACT
PA01863869-02OtherAMERICHOICE
PA01863869-03OtherAMERICHOICE
PA0018638690004Medicaid
PAF06778Medicare UPIN
PA0018638690003Medicaid