Provider Demographics
NPI:1689647810
Name:FEDERICO, CHERYL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:FEDERICO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MADISON AVE
Mailing Address - Street 2:STE A 06
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6092
Mailing Address - Country:US
Mailing Address - Phone:973-605-8040
Mailing Address - Fax:973-605-8085
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-971-5488
Practice Address - Fax:973-605-8085
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0632312080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine