1487890604 NPI number — MISS JOYCE CHERRY R.D.

Table of content: MISS JOYCE CHERRY R.D. (NPI 1487890604)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487890604 NPI number — MISS JOYCE CHERRY R.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHERRY
Provider First Name:
JOYCE
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
R.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487890604
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10205 BALTIMORE AVE APT 7105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLLEGE PARK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20740-4246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
246-460-8056
Provider Business Mailing Address Fax Number:
301-982-0130

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6301 IVY LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENBELT
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20770-1402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-460-8056
Provider Business Practice Location Address Fax Number:
310-982-0130
Provider Enumeration Date:
12/17/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  D01916 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)