Basic Information
Provider Information
NPI: 1508147323
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHERY
FirstName: NALDA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: TIBURCIO
OtherFirstName: NALDA
OtherMiddleName:  
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 42 BELL AVENUE
Address2:  
City: MOUNT VERNON
State: NY
PostalCode: 10550
CountryCode: US
TelephoneNumber: 9143768174
FaxNumber: 9143780180
Practice Location
Address1: 75 MORRIS AVENUE
Address2: EUGENIO MARIA DE HOSTOS MICROSOCIETY SCHOOL - WJCS
City: YONKER
State: NY
PostalCode: 10701
CountryCode: US
TelephoneNumber: 9143768174
FaxNumber: 9143780180
Other Information
ProviderEnumerationDate: 09/07/2011
LastUpdateDate: 09/07/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X083893NYY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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