Provider Demographics
NPI:1922230515
Name:MAMBRO, CHERYL TALBOT
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:TALBOT
Last Name:MAMBRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LONGWATER DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-1821
Mailing Address - Country:US
Mailing Address - Phone:781-871-5105
Mailing Address - Fax:
Practice Address - Street 1:40 LONGWATER DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1821
Practice Address - Country:US
Practice Address - Phone:781-871-5105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program