Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 3042681 | NY |
NPI | 1003476631 |
---|---|
Provider Name | Cheryl Schoedler |
First Address | Bay Shore, NY 11706-6115 |
Second Address | Bay Shore, NY 11706-6115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2019 |
Last Update Date | 17/06/2019 |