Provider Demographics
NPI:1356306484
Name:LUMBRUNO, CHERYL A (PT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:LUMBRUNO
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 1:61 LEE BROOK RD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:NH
Mailing Address - Zip Code:03285-6832
Mailing Address - Country:US
Mailing Address - Phone:603-726-8708
Mailing Address - Fax:603-536-2949
Practice Address - Street 1:15 TOWN WEST RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-3428
Practice Address - Country:US
Practice Address - Phone:603-536-2941
Practice Address - Fax:603-536-2949
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30396812Medicaid
NH000502502Medicare UPIN