Provider Demographics
NPI:1265740153
Name:COLANGELO, CHERYL ANN (OTL)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:COLANGELO
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 JUNE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-1202
Mailing Address - Country:US
Mailing Address - Phone:914-669-5317
Mailing Address - Fax:914-669-4326
Practice Address - Street 1:173 JUNE RD
Practice Address - Street 2:
Practice Address - City:NORTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10560-1202
Practice Address - Country:US
Practice Address - Phone:914-669-5317
Practice Address - Fax:914-669-4326
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000103225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist