Provider Demographics
NPI:1821818881
Name:CHEZ CHERY MEDSPA, LLC
Entity type:Organization
Organization Name:CHEZ CHERY MEDSPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERY
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:617-320-7709
Mailing Address - Street 1:49 PIERCE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-2931
Mailing Address - Country:US
Mailing Address - Phone:617-320-7709
Mailing Address - Fax:213-449-3877
Practice Address - Street 1:1201B HYDE PARK AVE
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-2808
Practice Address - Country:US
Practice Address - Phone:339-204-4337
Practice Address - Fax:213-449-3877
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEZ CHERY MEDSPA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty