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General NPI Number Information
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NPI Number | 1043846355
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Entity Type | Individual
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Provider Name | CHERYL DAMILATIS
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Gender | Female
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Dates
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Enumeration Date | 03/18/2020
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 495 CENTRAL PARK AVE STE 206
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City | SCARSDALE
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State | NY
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Zip | 10583-1038
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Country | US
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Telephone | 201-805-3012
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Fax |
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Provider Business Mailing Address
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Address Line | 25 BANK ST APT 210H
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City | WHITE PLAINS
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State | NY
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Zip | 10606-7004
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Country | US
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Telephone | 201-805-3012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 031589
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License Number State | NY
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