Provider Demographics
NPI:1194707463
Name:CHESKY, ALLA (MD)
Entity type:Individual
Prefix:DR
First Name:ALLA
Middle Name:
Last Name:CHESKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALLA
Other - Middle Name:
Other - Last Name:TCHESNOVETSKAYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1000
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:111 BEACH RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6668
Practice Address - Country:US
Practice Address - Phone:203-259-7442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153045207R00000X
CT036195207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3172074Medicaid
MAA22885Medicare PIN
110191945Medicare PIN
P00306305Medicare PIN
MA3172074Medicaid