MEDICARE: STEFANIE ANNE CHERUP MSS, MLSP, LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SW125886	PA

General Provider Information

NPI Number	:	1053645473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANIE ANNE CHERUP MSS, MLSP, LSW

Provider Business Mailing Address
First Line	:	268 SILVERBELL CT
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-7342
Country	:	US
Telephone Number	:	610-884-4254
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 W LANCASTER AVE
Second Line	:
City	:	WAYNE
State	:	PA
Zip	:	19087-4043
Country	:	US
Telephone Number	:	610-884-4254
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2009
Last Update Date	:	12/28/2009

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