Provider Demographics
NPI:1750403895
Name:CHERNUS, ANDREA R (RD)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:R
Last Name:CHERNUS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:17 HANOVER RD STE 440
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1409
Mailing Address - Country:US
Mailing Address - Phone:973-520-5520
Mailing Address - Fax:
Practice Address - Street 1:17 HANOVER RD STE 440
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932
Practice Address - Country:US
Practice Address - Phone:973-520-5520
Practice Address - Fax:212-579-9581
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004934-01133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
5122569OtherAETNA
2164184OtherUNITED HEALTHCARE
100216418401OtherUNITEDHEALTHCARE MEDICAID
3815250004OtherCIGNA HEALTHCARE
P2634767OtherOXFORD HEALTH PLANS