Provider Demographics
NPI:1437121076
Name:DRAKE, SHERYL (DC)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1694 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4002
Mailing Address - Country:US
Mailing Address - Phone:518-869-3884
Mailing Address - Fax:518-869-6030
Practice Address - Street 1:1694 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4002
Practice Address - Country:US
Practice Address - Phone:518-869-3884
Practice Address - Fax:518-869-6030
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008434-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDD5739Medicare ID - Type Unspecified
NYU65438Medicare UPIN