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General NPI Number Information
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NPI Number | 1568668663
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Entity Type | Individual
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Provider Name | CHERYL ROBYN ZAUDERER PHD, CNM, PMHNP-BC,
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Gender | Female
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 2 MEMAS CT
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City | DIX HILLS
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State | NY
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Zip | 11746-5224
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Country | US
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Telephone | 631-897-1285
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MEMAS CT
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City | DIX HILLS
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State | NY
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Zip | 11746-5224
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Country | US
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Telephone | 631-897-1285
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F400950-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | F400950-1
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License Number State | NY
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