Provider Demographics
NPI:1336545789
Name:WESTPHAL, CHERYL
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:
Last Name:WESTPHAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 E 44TH ST
Mailing Address - Street 2:APT 1219
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4400
Mailing Address - Country:US
Mailing Address - Phone:617-840-8521
Mailing Address - Fax:
Practice Address - Street 1:307 E 44TH ST
Practice Address - Street 2:APT 1219
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4400
Practice Address - Country:US
Practice Address - Phone:617-840-8521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY685129-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse