Basic Information
| Provider Information | |||||||||
| NPI: | 1922181361 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRABIK | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | |||||||||
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| Credential: | PNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 MAIN ST FL 5 | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142031009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163230220 | ||||||||
| FaxNumber: | 7163230293 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 MAIN ST FL 4 | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142031009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163230220 | ||||||||
| FaxNumber: | 7163230293 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2006 | ||||||||
| LastUpdateDate: | 01/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 454749 | NY | N | Nursing Service Providers | Registered Nurse | 363L00000X | 381396 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LP0200X | F381396 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 02323595 | 05 | NY | MEDICAID | 9512080 | 01 | NY | IHA | OTHER | 000560746002 | 01 | NY | BC/BS | OTHER | 00026586901 | 01 | NY | UNIVERA | OTHER | 051123000012 | 01 | NY | FIDELIS | OTHER |