Provider Demographics
NPI:1457456964
Name:MORRIS, CHERYL L (DC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:MORRIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-4423
Mailing Address - Country:US
Mailing Address - Phone:845-300-8002
Mailing Address - Fax:845-675-7182
Practice Address - Street 1:180 S BROADWAY
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-4423
Practice Address - Country:US
Practice Address - Phone:845-300-8002
Practice Address - Fax:845-675-7182
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXOO9837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX0F511Medicare PIN
NYU8Z595Medicare UPIN