Basic Information
| Provider Information | |||||||||
| NPI: | 1043232234 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHERRY | ||||||||
| FirstName: | LANCE | ||||||||
| MiddleName: | ELLIOT | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 E 50TH ST | ||||||||
| Address2: | APT. 5A | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100227682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127500460 | ||||||||
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| Practice Location | |||||||||
| Address1: | 33 IRVING PL | ||||||||
| Address2: | 9TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100032332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126773989 | ||||||||
| FaxNumber: | 2126773994 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 012671 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.