1780028076 NPI number — CHERIE SPANIER, PSY.D., LLC

Table of content: MAIFRAK JAILANE SOBRINO BSN, RN, CCRN (NPI 1477369049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780028076 NPI number — CHERIE SPANIER, PSY.D., LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHERIE SPANIER, PSY.D., LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1780028076
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1101 RICHMOND AVE
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
POINT PLEASANT BEACH
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08742-3010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-456-0450
Provider Business Mailing Address Fax Number:
732-295-2280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1101 RICHMOND AVE
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
POINT PLEASANT BEACH
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08742-3010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-456-0450
Provider Business Practice Location Address Fax Number:
732-295-2280
Provider Enumeration Date:
04/17/2013

Additional Information

Authorized Official

Authorized Official Last Name:
SPANIER
Authorized Official First Name:
CHERIE
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
732-456-0450

Provider Taxonomy Codes

  • Taxonomy code: 103TC2200X , with the licence number:  35SIOO464200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1891935011 . This is a "TYPE 1 NPI NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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