Provider Demographics
NPI:1336625144
Name:DIGIANNURIO, CHERYLANN
Entity type:Individual
Prefix:
First Name:CHERYLANN
Middle Name:
Last Name:DIGIANNURIO
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 1:820 PHIPPS CT
Mailing Address - Street 2:
Mailing Address - City:YAPHANK
Mailing Address - State:NY
Mailing Address - Zip Code:11980-2053
Mailing Address - Country:US
Mailing Address - Phone:631-433-9143
Mailing Address - Fax:
Practice Address - Street 1:820 PHIPPS CT
Practice Address - Street 2:
Practice Address - City:YAPHANK
Practice Address - State:NY
Practice Address - Zip Code:11980-2053
Practice Address - Country:US
Practice Address - Phone:631-433-9143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-15
Last Update Date:2018-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency