Provider Demographics
NPI:1831337153
Name:TARATETA, CHERYL ANN (DC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:TARATETA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CAVALCADE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3420
Mailing Address - Country:US
Mailing Address - Phone:508-723-4494
Mailing Address - Fax:
Practice Address - Street 1:4 FAITH AVENUE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501
Practice Address - Country:US
Practice Address - Phone:508-723-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00548111N00000X
NH788-0707111N00000X
MA3125111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor