Provider Demographics
NPI:1063177814
Name:CHERNACK, PETER IAN (MSW, LCSW-R, DSW)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:IAN
Last Name:CHERNACK
Suffix:
Gender:M
Credentials:MSW, LCSW-R, DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 PEARSON ST APT 7K
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4367
Mailing Address - Country:US
Mailing Address - Phone:516-241-1297
Mailing Address - Fax:
Practice Address - Street 1:226 E 52ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-6201
Practice Address - Country:US
Practice Address - Phone:212-712-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-06
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0259661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical