Provider Demographics
NPI:1164501086
Name:HSIUNG, SHERRY H (MD)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:H
Last Name:HSIUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CHAMBERS ST
Mailing Address - Street 2:APT 9A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1131
Mailing Address - Country:US
Mailing Address - Phone:917-854-1018
Mailing Address - Fax:212-766-0806
Practice Address - Street 1:7901 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3957
Practice Address - Country:US
Practice Address - Phone:718-491-5800
Practice Address - Fax:718-748-2151
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222828207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI49852Medicare UPIN