Provider Demographics
NPI:1881579902
Name:CHEESE, LOI
Entity type:Individual
Prefix:
First Name:LOI
Middle Name:
Last Name:CHEESE
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 1:9159 191ST ST APT 1D
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2876
Mailing Address - Country:US
Mailing Address - Phone:347-303-0123
Mailing Address - Fax:
Practice Address - Street 1:9159 191ST ST APT 1D
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2876
Practice Address - Country:US
Practice Address - Phone:347-303-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344460-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse