Provider Demographics
NPI:1982845954
Name:CHARLTON, SHERYL (ATC)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:CHARLTON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HANNA PL UPPR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2218
Mailing Address - Country:US
Mailing Address - Phone:518-848-1206
Mailing Address - Fax:
Practice Address - Street 1:7 HANNA PL UPPR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2218
Practice Address - Country:US
Practice Address - Phone:518-848-1206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001066-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer