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1992006456 NPI number — CHERYL ANN GREENE PTA-PHYSICAL THERAPI

NPI Number: 1992006456
Health Care Provider/Practitioner: CHERYL ANN GREENE PTA-PHYSICAL THERAPI

Information about “1992006456” NPI (CHERYL ANN GREENE PTA-PHYSICAL THERAPI) exists in 1992006456 in HTML format HTML  |  1992006456 in plain Text format TXT  |  1992006456 in PDF (Portable Document Format) PDF  |  1992006456 in an XML format XML  formats.

NPI Number : 1992006456 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1992006456",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GREENE",
    "FirstName": "CHERYL",
    "MiddleName": "ANN",
    "NamePrefix": "MISS",
    "NameSuffix": null,
    "Credential": "PTA-PHYSICAL THERAPI",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DEPUE",
    "OtherFirstName": "CHERYL",
    "OtherMiddleName": "ANN",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "PTA-PHYSICAL THERAPI",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 923 LIBERTY , NY 12754",
    "SecondLineMailingAddress": "29 SCHOOLHOUSE ROAD, LIVINGTON MANOR NY 12758",
    "MailingAddressCityName": "LIBERTY",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "12754",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "845-439-1182",
    "MailingAddressFaxNumber": "845-439-1115",
    "FirstLinePracticeLocationAddress": "29 SCHOOLHOUSE ROAD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LIBERTY",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "12754",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "845-439-1182",
    "PracticeLocationAddressFaxNumber": "845-439-1115",
    "EnumerationDate": "11/15/2010",
    "LastUpdateDate": "08/24/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225200000X",
        "TaxonomyName": "Physical Therapy Assistant",
        "LicenseNumber": "002719-1",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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