Provider Demographics
NPI:1952417867
Name:DEAN, CHERYL (PA-C)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:150 S HUNTINGTON AVE
Mailing Address - Street 2:V.A. MEDICAL CENTER/MAIL CODE 127
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4817
Mailing Address - Country:US
Mailing Address - Phone:857-364-4809
Mailing Address - Fax:
Practice Address - Street 1:VA BOSTON MEDICAL CENTER
Practice Address - Street 2:1400 VFW PARKWAY
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132
Practice Address - Country:US
Practice Address - Phone:857-364-5289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2014-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA769363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant