Provider Demographics
NPI:1699989574
Name:BENZ, CHERYL M (NP)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:M
Last Name:BENZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:A
Other - Last Name:MERCADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 473
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07303-0473
Mailing Address - Country:US
Mailing Address - Phone:201-222-1170
Mailing Address - Fax:201-222-1159
Practice Address - Street 1:142 PALISADE AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1133
Practice Address - Country:US
Practice Address - Phone:201-222-1170
Practice Address - Fax:201-222-1159
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7261339363LA2100X
NJ26NJ00150700363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care