Provider Demographics
NPI:1811465867
Name:LORDI, CHERYL (RN)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:LORDI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 OAK HILL DR
Mailing Address - Street 2:
Mailing Address - City:EAST NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:11732-1115
Mailing Address - Country:US
Mailing Address - Phone:516-526-7890
Mailing Address - Fax:
Practice Address - Street 1:37 IRVING PL
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-2314
Practice Address - Country:US
Practice Address - Phone:516-526-7890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY669054-1163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice