Provider Demographics
NPI:1023152006
Name:LUFRANO, CHERYL (RPA-C)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:LUFRANO
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2177 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6603
Mailing Address - Country:US
Mailing Address - Phone:718-370-3730
Mailing Address - Fax:718-698-9412
Practice Address - Street 1:2177 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6603
Practice Address - Country:US
Practice Address - Phone:718-370-3730
Practice Address - Fax:718-948-9090
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002426363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002426OtherLICENCE
NYS68337Medicare UPIN