Provider Demographics
NPI:1023198587
Name:SHAPIRO, CHERYL JENNIFER (ATC, LMT)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:JENNIFER
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:ATC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SPRUCEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-3810
Mailing Address - Country:US
Mailing Address - Phone:516-622-5404
Mailing Address - Fax:309-402-5219
Practice Address - Street 1:17A S PARK AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5247
Practice Address - Country:US
Practice Address - Phone:516-255-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0002902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer