MEDICARE: JEAN R CHERY

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	163W00000X	Registered Nurse	610646	NY

General Provider Information

NPI Number	:	1912134776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN R CHERY

Provider Business Mailing Address
First Line	:	1839 TWAIN ST
Second Line	:
City	:	NORTH BALDWIN
State	:	NY
Zip	:	11510-2340
Country	:	US
Telephone Number	:	516-223-4832
Fax Number	:

Provider Business Practice Location Address
First Line	:	1839 TWAIN ST
Second Line	:
City	:	NORTH BALDWIN
State	:	NY
Zip	:	11510-2340
Country	:	US
Telephone Number	:	516-223-4832
Fax Number	:

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

Provider Enumeration Date	:	06/18/2009
Last Update Date	:	06/18/2009

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Directions to “ JEAN R CHERY ” Practice Location

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