Provider Demographics
NPI:1407913734
Name:ROBERT E SHERMAN DPM
Entity Type:Organization
Organization Name:ROBERT E SHERMAN DPM
Other - Org Name:STRATFORD PODIATRY ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-375-1370
Mailing Address - Street 1:3446 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4118
Mailing Address - Country:US
Mailing Address - Phone:203-375-1370
Mailing Address - Fax:203-377-2410
Practice Address - Street 1:3446 MAIN ST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4118
Practice Address - Country:US
Practice Address - Phone:203-375-1370
Practice Address - Fax:203-377-2410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000188213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004050688Medicaid
CTC00096Medicare PIN
CT004050688Medicaid
CT0576970001Medicare NSC