Provider Demographics
NPI:1861647737
Name:BORKHOLDER, CHERYL ELAINE (PT,DPT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ELAINE
Last Name:BORKHOLDER
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8225 164TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1120
Mailing Address - Country:US
Mailing Address - Phone:718-374-0002
Mailing Address - Fax:718-380-3214
Practice Address - Street 1:8225 164TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1120
Practice Address - Country:US
Practice Address - Phone:718-374-0002
Practice Address - Fax:718-380-3214
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025005-12251P0200X
IN05005002A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics