Provider Demographics
NPI:1154737443
Name:CHERESNICK, COREY (MD)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:CHERESNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4439 STATE ROUTE 159 STE G70
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-7203
Mailing Address - Country:US
Mailing Address - Phone:740-779-4598
Mailing Address - Fax:
Practice Address - Street 1:4437 STATE ROUTE 159 STE G15
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-7065
Practice Address - Country:US
Practice Address - Phone:740-779-4598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.132333207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology