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General NPI Number Information
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NPI Number | 1871783878
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Entity Type | Individual
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Provider Name | DORIS CHERRY
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Gender | Female
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 428 COLUMBUS AVE
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City | NEW HAVEN
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State | CT
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Zip | 06519-1233
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Country | US
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Telephone | 203-503-3164
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Fax |
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Provider Business Mailing Address
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Address Line | 93 DIX ST HAMDEN
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City | HAMDEN
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State | CT
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Zip | 06514-4930
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Country | US
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Telephone | 203-772-4662
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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