Healthcare Provider Details

I. General information

NPI: 1871066944
Provider Name (Legal Business Name): CHEROKEE GELIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 E 40TH ST FL 12
NEW YORK NY
10016-0113
US

IV. Provider business mailing address

929 COURTLANDT AVE APT 5D
BRONX NY
10451-1877
US

V. Phone/Fax

Practice location:
  • Phone: 646-986-6038
  • Fax:
Mailing address:
  • Phone: 646-986-6038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: