Provider Demographics
NPI:1043409857
Name:CHENEY, RALPH L (PT)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:L
Last Name:CHENEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 29TH ST
Mailing Address - Street 2:
Mailing Address - City:COPIAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11726-2618
Mailing Address - Country:US
Mailing Address - Phone:631-671-4099
Mailing Address - Fax:516-833-5843
Practice Address - Street 1:417 29TH ST
Practice Address - Street 2:
Practice Address - City:COPIAGUE
Practice Address - State:NY
Practice Address - Zip Code:11726-2618
Practice Address - Country:US
Practice Address - Phone:631-671-4099
Practice Address - Fax:516-833-5843
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004042225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist