Provider Demographics
NPI:1528869286
Name:CHERY, BETINA
Entity type:Individual
Prefix:
First Name:BETINA
Middle Name:
Last Name:CHERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2971 W OLD STATE RD APT 20
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5400
Mailing Address - Country:US
Mailing Address - Phone:518-545-7704
Mailing Address - Fax:
Practice Address - Street 1:2971 W OLD STATE RD APT 20
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5400
Practice Address - Country:US
Practice Address - Phone:518-545-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3136702164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse