Cherbukovsky, Gregory A
Cherbukovsky, Gregory A is an individual health care provider with primary practice located at W63N541 Hanover Ave , Cedarburg WI 53012-1917. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant is his primary health care specialty. Cherbukovsky, Gregory A can be contacted via phone (262) 375-2195.Contact Information
Primary practice address
W63N541 Hanover Ave
Cedarburg WI 53012-1917
Phone: (262) 375-2195
Fax: (262) 375-2273
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | 469-019 | Wisconsin |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | 718-046 | Wisconsin |
Profile Details
| NPI number | 1730189069 |
|---|---|
| LBN Legal business name | Cherbukovsky, Gregory A |
| Credentials | Physical Therapist Assistant (PTA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730189069 | NPPES |
| Wisconsin | MEDICAID | 40395700 |
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