Provider Demographics
NPI:1326241647
Name:KOIVUNEN, SHERRY (RNFA)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:KOIVUNEN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PLASTIC AND RECONSTRUCTIVE SURGERY
Mailing Address - Street 2:400 EAST MAIN STREET
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-242-7610
Mailing Address - Fax:914-241-3239
Practice Address - Street 1:PLASTIC AND RECONSTRUCTIVE SURGERY
Practice Address - Street 2:400 EAST MAIN STREET
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-242-7610
Practice Address - Fax:914-241-3239
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4980661374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician