Provider Demographics
NPI:1912739921
Name:CHALAK, CHEREEN ZAKIEH (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:CHEREEN
Middle Name:ZAKIEH
Last Name:CHALAK
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:UPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01568-1508
Mailing Address - Country:US
Mailing Address - Phone:508-498-9331
Mailing Address - Fax:
Practice Address - Street 1:71 NEEDHAM ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02461-1663
Practice Address - Country:US
Practice Address - Phone:857-598-4460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2372641363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily