Provider Demographics
NPI:1972331056
Name:CHERY, CHERYL NATALIE
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:NATALIE
Last Name:CHERY
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 1:11 OAK CREST DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3920
Mailing Address - Country:US
Mailing Address - Phone:631-662-3903
Mailing Address - Fax:
Practice Address - Street 1:11 OAK CREST DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3920
Practice Address - Country:US
Practice Address - Phone:631-662-3903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35045801164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse