# IRA CHERNOFF,MD PCI

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124105705
- **Authorized official:** MS. CYNTHIA A DI BELLA-PRICE NP-CFA (NURSE PRACTITIONER/FIRST ASSIST)
- **Authorized official phone:** (631) 246-6100

## Contact information

- **Practice address:** 2500 NESCONSET HWY BLDG 20A, STONY BROOK, NY 11790-2564
- **Practice address phone:** (631) 246-6100
- **Practice address fax:** (631) 246-9464
- **Mailing address:** 2500 NESCONSET HWY BLDG 20A, STONY BROOK, NY 11790-2564
- **Mailing address phone:** (631) 246-6100
- **Mailing address fax:** (631) 246-9464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 302541 | NY | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 08/22/2020