Individual
CHERAY SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 CLEVELAND ST, VALLEY STREAM, NY 11580-6003
(516) 823-0739
Mailing address
23528 148TH AVE, ROSEDALE, NY 11422-3257
(347) 553-6122
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10 311713
NY
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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