Provider Demographics
NPI:1477608966
Name:SFERRA, TINA M (MSPT)
Entity Type:Individual
Prefix:MS
First Name:TINA
Middle Name:M
Last Name:SFERRA
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MRS
Other - First Name:TINA
Other - Middle Name:M
Other - Last Name:DEMPSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:PO BOX 179
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-0179
Mailing Address - Country:US
Mailing Address - Phone:917-476-2164
Mailing Address - Fax:914-245-3905
Practice Address - Street 1:175 E MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2973
Practice Address - Country:US
Practice Address - Phone:917-847-9487
Practice Address - Fax:914-245-3905
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021697225100000X, 2251S0007X, 2251X0800X, 2251H1200X, 2251N0400X, 2251P0200X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ19M21Medicare ID - Type Unspecified