Individual
CHERYL SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
54 WESTCHESTER AVE, ROCHESTER, NY 14609-4231
(585) 287-5563
Mailing address
54 WESTCHESTER AVE, ROCHESTER, NY 14609-4231
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
194493-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194493
—
NY
05
—
194493-1
—
NY
Enumeration date
01/04/2018
Last updated
01/04/2018
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