Provider Demographics
NPI:1801173174
Name:DOREMUS, CHERYL CONNOR (RN/BSN)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:CONNOR
Last Name:DOREMUS
Suffix:
Gender:F
Credentials:RN/BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WARD SQ
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13365-1606
Mailing Address - Country:US
Mailing Address - Phone:315-823-2280
Mailing Address - Fax:315-823-3652
Practice Address - Street 1:1 WARD SQ
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NY
Practice Address - Zip Code:13365-1606
Practice Address - Country:US
Practice Address - Phone:315-823-2280
Practice Address - Fax:315-823-3652
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY358441-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool