Healthcare Provider Details

I. General information

NPI: 1215831342
Provider Name (Legal Business Name): KATIA CHERY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 PLUNKETT DR
RANDOLPH MA
02368-3623
US

IV. Provider business mailing address

15 PLUNKETT DR
RANDOLPH MA
02368-3623
US

V. Phone/Fax

Practice location:
  • Phone: 617-721-3296
  • Fax:
Mailing address:
  • Phone: 617-721-3296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2269033
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: