Chertok, Russell James

Chertok, Russell James is an individual health care provider with primary practice located at 900 Walt Whitman Rd Ste Ll1 , Melville NY 11747-2215. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Chertok, Russell James can be contacted via phone (516) 698-5511.

Contact Information

Primary practice address
900 Walt Whitman Rd Ste Ll1 Melville NY 11747-2215
Phone: (516) 698-5511
Fax: (516) 418-5377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 088454-1 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 085396-1 New York

Profile Details

NPI number 1851631782
LBN Legal business name Chertok, Russell James
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2013
Last updated Jan 15th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851631782 NPPES
New York MEDICAID 03003069

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