Individual
CRAIG S CHERTACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 MEMORIAL DR, BERLIN, WI 54923-1243
(920) 361-1313
Mailing address
331 FORESTVIEW DR, WILLIAMSVILLE, NY 14221-1460
(716) 689-7541
(716) 689-7541
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
169890
NY
207X00000X
Orthopaedic Surgery Physician
169890
NY
207X00000X
Orthopaedic Surgery Physician
18247
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076011
MEDICARE GROUP NUMBER
NY
Enumeration date
11/18/2005
Last updated
03/28/2018
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