Provider Demographics
NPI:1083091524
Name:BLAU, CHERYL (MS, OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:BLAU
Suffix:
Gender:F
Credentials:MS, OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W END AVE
Mailing Address - Street 2:SUITE 1M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4902
Mailing Address - Country:US
Mailing Address - Phone:212-600-4781
Mailing Address - Fax:
Practice Address - Street 1:180 W END AVE
Practice Address - Street 2:SUITE 1M
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4902
Practice Address - Country:US
Practice Address - Phone:212-600-4781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014987-1261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation