Provider Demographics
NPI:1790923159
Name:PALERMO, CHERYL A (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:A
Last Name:PALERMO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:A
Other - Last Name:BLOOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:DIVERSIFIED
Mailing Address - Street 2:2900 DELAWARE AVE
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217
Mailing Address - Country:US
Mailing Address - Phone:716-871-9883
Mailing Address - Fax:
Practice Address - Street 1:DIVERSIFIED
Practice Address - Street 2:2900 DELAWARE AVE
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217
Practice Address - Country:US
Practice Address - Phone:716-871-9883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014341-1282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital