Provider Demographics
NPI:1669762324
Name:CHERRY, NICOLE MAUREEN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MAUREEN
Last Name:CHERRY
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:MAUREEN
Other - Last Name:SWEENEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:91 MAIN ST STE 112
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-4437
Mailing Address - Country:US
Mailing Address - Phone:401-289-2999
Mailing Address - Fax:401-289-2950
Practice Address - Street 1:91 MAIN ST STE 122
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:RI
Practice Address - Zip Code:02885-4437
Practice Address - Country:US
Practice Address - Phone:401-289-2999
Practice Address - Fax:401-289-2950
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01785225100000X
OHPT-010693225100000X
NYPT-021510225100000X
MAPT-15672225100000X
RIPT-01785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist