Provider Demographics
NPI:1043416050
Name:LACSINA, CHERRY C (PT)
Entity Type:Individual
Prefix:
First Name:CHERRY
Middle Name:C
Last Name:LACSINA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 LEBER AVE
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-1941
Mailing Address - Country:US
Mailing Address - Phone:908-279-9280
Mailing Address - Fax:
Practice Address - Street 1:236 E WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-2084
Practice Address - Country:US
Practice Address - Phone:732-376-1800
Practice Address - Fax:732-376-1804
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01241400261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy