Provider Demographics
NPI:1750696084
Name:PALGON, CHERYL
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:PALGON
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 1:387 GRAND ST
Mailing Address - Street 2:# K1403
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-3969
Mailing Address - Country:US
Mailing Address - Phone:212-529-9366
Mailing Address - Fax:
Practice Address - Street 1:387 GRAND ST
Practice Address - Street 2:# K1403
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-3969
Practice Address - Country:US
Practice Address - Phone:212-529-9366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
4046174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist