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General NPI Number Information
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NPI Number | 1821818881
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Entity Type | Organization
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Legal Business Name | CHEZ CHERY MEDSPA, LLC
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 1201B HYDE PARK AVE
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City | HYDE PARK
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State | MA
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Zip | 02136-2808
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Country | US
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Telephone | 339-204-4337
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Fax | 213-449-3877
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Provider Business Mailing Address
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Address Line | 49 PIERCE ST APT 2
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City | HYDE PARK
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State | MA
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Zip | 02136-2931
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Country | US
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Telephone | 617-320-7709
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Fax | 213-449-3877
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHERLINE CHERY
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Credential | NURSE PRACTITIONER
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Telephone | 617-320-7709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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