Provider Demographics
NPI:1730615444
Name:CHERPEL, POLINA (SRNA)
Entity type:Individual
Prefix:MRS
First Name:POLINA
Middle Name:
Last Name:CHERPEL
Suffix:
Gender:F
Credentials:SRNA
Other - Prefix:MISS
Other - First Name:POLINA
Other - Middle Name:
Other - Last Name:CHTCHERBAKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 ELISE TERRACE
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M2R2X1
Mailing Address - Country:CA
Mailing Address - Phone:416-450-2958
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY687755367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY367500000XMedicaid