Cheryl Ann Greene, PTA-PHYSICAL THERAPI

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

002719-1 Issued in NY

Practice address

29 Schoolhouse Road
Liberty, NY 12754

Phone

(845) 439-1182

Fax

(845) 439-1115

NPI assigned

Nov 15, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Cheryl Ann Depue Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1992006456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 923 LIBERTY , NY 12754",
            "address_2": "29 SCHOOLHOUSE ROAD, LIVINGTON MANOR NY 12758",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "12754",
            "telephone_number": "845-439-1182",
            "fax_number": "845-439-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 SCHOOLHOUSE ROAD",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "12754",
            "telephone_number": "845-439-1182",
            "fax_number": "845-439-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PTA-PHYSICAL THERAPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "002719-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "DEPUE",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "PTA-PHYSICAL THERAPI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Herman Gonzalez, AAS
• Olivia Gorr, LMSW
• Greater Adult Neighbors Inc (Arcadia Residence)
• John Joseph Green, L.C.S.W.
• Tyler Green
• David Greenfield, P.T.
• Michelle Anne Entoma Guanzon, P.T.
• Rommel Guanzon
• Susan E Hahn, LMSW
• Jill Harmon, LCSW

• Physical Therapy Assistant in Liberty, NY
• Providers in Liberty, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.