MEDICARE: MRS. SHERYL AMOR LUGAY PAULO

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	225100000X	Physical Therapist	024601-1	NY

General Provider Information

NPI Number	:	1942417951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHERYL AMOR LUGAY PAULO

Provider Business Mailing Address
First Line	:	3324 WALLACE AVE
Second Line	:	APT 1
City	:	BRONX
State	:	NY
Zip	:	10467
Country	:	US
Telephone Number	:	917-907-1826
Fax Number	:

Provider Business Practice Location Address
First Line	:	3324 WALLACE AVE
Second Line	:	APT 1
City	:	BRONX
State	:	NY
Zip	:	10467
Country	:	US
Telephone Number	:	917-907-1826
Fax Number	:

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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