Provider Demographics
NPI:1689937583
Name:LEVERTON, CHERYL B (MSED)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:B
Last Name:LEVERTON
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WHITE BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3405
Mailing Address - Country:US
Mailing Address - Phone:845-596-8193
Mailing Address - Fax:
Practice Address - Street 1:14 WHITE BIRCH DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3405
Practice Address - Country:US
Practice Address - Phone:845-596-8193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-17
Last Update Date:2012-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY654866951174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist