Provider Demographics
NPI:1699115477
Name:CHERNIAK, ANGELA (OD)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:CHERNIAK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2003
Mailing Address - Country:US
Mailing Address - Phone:413-584-6666
Mailing Address - Fax:
Practice Address - Street 1:269 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01062-2003
Practice Address - Country:US
Practice Address - Phone:413-584-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5334152W00000X
ALS-D11-TA-955152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist