Provider Demographics
NPI:1093899585
Name:HAMMOND, SHERRY PATRICE (OT)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:PATRICE
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5307 AVENUE K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3337
Mailing Address - Country:US
Mailing Address - Phone:917-319-5592
Mailing Address - Fax:347-426-4527
Practice Address - Street 1:5307 AVENUE K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3337
Practice Address - Country:US
Practice Address - Phone:917-319-5592
Practice Address - Fax:347-426-4527
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013471-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02847047Medicaid