Provider Demographics
NPI:1538597950
Name:DINEROS, CHERRY (MSED, TSHH)
Entity type:Individual
Prefix:
First Name:CHERRY
Middle Name:
Last Name:DINEROS
Suffix:
Gender:F
Credentials:MSED, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 HENRY ST FL 2
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3602
Mailing Address - Country:US
Mailing Address - Phone:516-225-3469
Mailing Address - Fax:
Practice Address - Street 1:104 S TERRACE PL
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580
Practice Address - Country:US
Practice Address - Phone:516-225-3469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY752973174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist