1780820001 NPI number — CHERRY VALLEY PHYSICAL THERAPY, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780820001 NPI number — CHERRY VALLEY PHYSICAL THERAPY, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHERRY VALLEY PHYSICAL THERAPY, PLLC
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:
1780820001
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3959 MOSLEY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAZENOVIA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13035-9498
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-815-4266
Provider Business Mailing Address Fax Number:
315-815-4267

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 NELSON ST
Provider Second Line Business Practice Location Address:
TOWN & COUNTRY PLAZA
Provider Business Practice Location Address City Name:
CAZENOVIA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13035-1322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-815-4266
Provider Business Practice Location Address Fax Number:
315-815-4267
Provider Enumeration Date:
12/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MCFARLAND
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
JEANNE
Authorized Official Title or Position:
SOLE PROPRIETOR
Authorized Official Telephone Number:
315-815-4266

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  6716 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com