Provider Demographics
NPI:1962795534
Name:ESCANO, CHERYL (PT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:ESCANO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 DUBOIS ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-4851
Mailing Address - Country:US
Mailing Address - Phone:845-568-2396
Mailing Address - Fax:845-568-2946
Practice Address - Street 1:70 DUBOIS ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-4851
Practice Address - Country:US
Practice Address - Phone:845-568-2395
Practice Address - Fax:845-568-2946
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031962-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist