Provider Demographics
NPI:1861253809
Name:NEUNDORF, CHERYL J
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:J
Last Name:NEUNDORF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 PARKER ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3124
Mailing Address - Country:US
Mailing Address - Phone:419-612-1822
Mailing Address - Fax:
Practice Address - Street 1:426 PARKER ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3124
Practice Address - Country:US
Practice Address - Phone:419-612-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care