Provider Demographics
NPI:1629296280
Name:CHERY, WITNY (COTA)
Entity Type:Individual
Prefix:
First Name:WITNY
Middle Name:
Last Name:CHERY
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2949 HAMMOND PL
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-4037
Mailing Address - Country:US
Mailing Address - Phone:215-884-0131
Mailing Address - Fax:
Practice Address - Street 1:2949 HAMMOND PL
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-4037
Practice Address - Country:US
Practice Address - Phone:215-884-0131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006013224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant