Provider Demographics
NPI:1235384975
Name:CAPEK, CHERYL N (RN)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:N
Last Name:CAPEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:N
Other - Last Name:STONBORG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:57 LAKESIDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-1801
Mailing Address - Country:US
Mailing Address - Phone:631-737-0569
Mailing Address - Fax:
Practice Address - Street 1:57 LAKESIDE AVENUE
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-1801
Practice Address - Country:US
Practice Address - Phone:631-737-0569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346140-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse