Provider Demographics
NPI:1144513201
Name:JAMES, SHERRY (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 VERNON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1616
Mailing Address - Country:US
Mailing Address - Phone:914-356-0200
Mailing Address - Fax:914-237-2356
Practice Address - Street 1:76 VERNON AVE FL 2
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1616
Practice Address - Country:US
Practice Address - Phone:914-356-0200
Practice Address - Fax:914-237-2356
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283016164W00000X
NY839407163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1144513201Medicaid