Sage Otolaryngology PLLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

SAGE OTOLARYNGOLOGY PLLC

Practice address

1010 Medical Center Dr
Powderly, KY 42367-5463

Phone

(917) 846-4617

NPI assigned

Aug 28, 2006

Last updated

Jun 9, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Boris Chernobilsky, M.D.NPI 1609821297

Title

Member

Phone

(917) 846-4617

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Boris Chernobilsky, M.D.

  • Otolaryngology Physician
  • New York, NY
  • NPI 1609821297
  NPD (past) Authorized official
• Pamela Ison-Glover

  • Audiologist
  • Hopkinsville, KY
  • NPI 1467458141
  NPD (past)
• Marina Boruk, MD

  • Otolaryngology Physician
  • Brooklyn, NY
  • NPI 1235166281
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1548378680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10440 QUEENS BLVD",
            "address_2": "11V",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753637",
            "telephone_number": "917-846-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MEDICAL CENTER DR",
            "city": "POWDERLY",
            "state": "KY",
            "postal_code": "423675463",
            "telephone_number": "917-846-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE OTOLARYNGOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "CHERNOBILSKY",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-846-4617",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy M Powell, ARNP
• Jane Hope Reed, APRN
• Sarah J. Renschler, RDN. LD
• Laurie Roberts, ARNP
• Brenda N Rogers, LMT
• William Edward Shuttleworth, MD
• Tracey E. Sloan, APRN
• Jonathan Tyler Smith, MD
• Stephen Wood, OD
• Kylee Stroud

• Otolaryngology Physician in Powderly, KY
• Providers in Powderly, KY by specialty
• Otolaryngology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.