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General NPI Number Information
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NPI Number | 1588855563
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Entity Type | Individual
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Provider Name | CHERYL EDELMAN II
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Gender | Female
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 184 HALLOCK RD APT 5D2
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City | LAKE GROVE
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State | NY
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Zip | 11755-1409
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Country | US
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Telephone | 631-721-3237
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Fax |
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Provider Business Mailing Address
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Address Line | 184 HALLOCK RD APT 5D2
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City | LAKE GROVE
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State | NY
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Zip | 11755-1409
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Country | US
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Telephone |
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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