Provider Demographics
NPI:1306036025
Name:SPERLING, MARI CHERIE (MD)
Entity Type:Individual
Prefix:
First Name:MARI
Middle Name:CHERIE
Last Name:SPERLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARI
Other - Middle Name:CHERIE
Other - Last Name:BERTONI SPERLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:24 HOSPITAL AVE 7 SOUTH
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810
Mailing Address - Country:US
Mailing Address - Phone:203-739-6980
Mailing Address - Fax:203-739-6981
Practice Address - Street 1:24 HOSPITAL AVE 7 S
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810
Practice Address - Country:US
Practice Address - Phone:203-739-6980
Practice Address - Fax:203-739-6981
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2455302084P0800X
CT0456442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT11737599OtherCAQH #
CT001456442Medicaid
CT001456442Medicaid