Provider Demographics
NPI:1487616579
Name:CHERNOFF, ARTHUR
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:CHERNOFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E OLNEY AVE
Mailing Address - Street 2:SUITE 505
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120
Mailing Address - Country:US
Mailing Address - Phone:215-456-7000
Mailing Address - Fax:215-254-2599
Practice Address - Street 1:50 TOWNSHIP LINE RD
Practice Address - Street 2:SUITE G-01
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2249
Practice Address - Country:US
Practice Address - Phone:215-572-5200
Practice Address - Fax:215-572-6456
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021675E207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019422650003Medicaid
PA0019422650003Medicaid
089498Medicare ID - Type Unspecified