=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598104499
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHERRIL M RHAMDEOW FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2013
-----------------------------------------------------
Last Update Date | 02/28/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5 GRACE CHURCH ST
-----------------------------------------------------
City | PORT CHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10573-4911
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-973-8899
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 165 MAIN ST
-----------------------------------------------------
City | OSSINING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10562-4702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-941-1263
-----------------------------------------------------
Fax | 914-941-0993
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WH0200X
-----------------------------------------------------
Taxonomy Name | Home Health Registered Nurse
-----------------------------------------------------
License Number | 33337713
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F337713
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | F337713
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------