Provider Demographics
NPI:1568257384
Name:CHERY, CASSANDRA M
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:M
Last Name:CHERY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S BORDER RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-1629
Mailing Address - Country:US
Mailing Address - Phone:781-866-6436
Mailing Address - Fax:
Practice Address - Street 1:50 S BORDER RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-1629
Practice Address - Country:US
Practice Address - Phone:781-866-6436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2300582163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse