Provider Demographics
NPI:1073501029
Name:SHERMAN, RICHARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 JERICHO TPKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2100
Mailing Address - Country:US
Mailing Address - Phone:516-488-1131
Mailing Address - Fax:516-488-1151
Practice Address - Street 1:199 JERICHO TPKE
Practice Address - Street 2:SUITE 202
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2100
Practice Address - Country:US
Practice Address - Phone:516-488-1131
Practice Address - Fax:516-488-1151
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003153213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP35372Medicare ID - Type UnspecifiedMEDICARE-BLUE CROSS
NYT32110Medicare UPIN
NY1009890001Medicare NSC