Individual
MS. CHERYL DENISE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
170 SOUTHRIDGE DR, ROCHESTER, NY 14626-4221
(585) 880-6171
Mailing address
170 SOUTHRIDGE DR, ROCHESTER, NY 14626-4221
(585) 880-6171
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
491205-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
491205 01
—
NY
Enumeration date
05/27/2011
Last updated
05/27/2011
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