Provider Demographics
NPI:1427235357
Name:SABLE-WOOD, CHERYL J
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:J
Last Name:SABLE-WOOD
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 1:929 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1759
Mailing Address - Country:US
Mailing Address - Phone:516-569-1689
Mailing Address - Fax:516-569-4338
Practice Address - Street 1:929 BROADWAY
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1759
Practice Address - Country:US
Practice Address - Phone:516-569-1689
Practice Address - Fax:516-569-4338
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist