Provider Demographics
NPI: | 1467718247 |
---|---|
Name: | SHERMAN MEDICAL CARE, PC |
Entity Type: | Organization |
Organization Name: | SHERMAN MEDICAL CARE, PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SANGITA |
Authorized Official - Middle Name: | T |
Authorized Official - Last Name: | SHAH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 212-569-2035 |
Mailing Address - Street 1: | 115 BRAMBLEBROOK ROAD |
Mailing Address - Street 2: | |
Mailing Address - City: | ARDSLEY |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10502-2206 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 212-569-2035 |
Mailing Address - Fax: | 212-569-2037 |
Practice Address - Street 1: | 231 SHERMAN AVE, 1F |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10034 |
Practice Address - Country: | US |
Practice Address - Phone: | 212-569-2035 |
Practice Address - Fax: | 212-569-2037 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-04-06 |
Last Update Date: | 2012-04-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty |