Provider Demographics
NPI:1376604264
Name:DUKSIN, SHERRY (MA CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:
Last Name:DUKSIN
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 W END AVE
Mailing Address - Street 2:APT. 19B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5401
Mailing Address - Country:US
Mailing Address - Phone:212-580-7174
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:DEPT. REHAB MEDICINE 6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-3311
Practice Address - Fax:212-562-3606
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002101-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist