Provider Demographics
NPI:1033130489
Name:HERSCHENHORN, SHARI (PT)
Entity Type:Individual
Prefix:MISS
First Name:SHARI
Middle Name:
Last Name:HERSCHENHORN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 S SEACREST BLVD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7944
Mailing Address - Country:US
Mailing Address - Phone:561-395-2117
Mailing Address - Fax:561-395-4551
Practice Address - Street 1:1401 NW 9TH AVE
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1304
Practice Address - Country:US
Practice Address - Phone:561-395-2117
Practice Address - Fax:561-395-4551
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT00107252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY7301Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID#