Provider Demographics
NPI:1487816609
Name:MARTIN, SHERRY LEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LEE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 LAMARCK DR
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4559
Mailing Address - Country:US
Mailing Address - Phone:716-839-9290
Mailing Address - Fax:
Practice Address - Street 1:123 LAMARCK DR
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:NY
Practice Address - Zip Code:14226-4559
Practice Address - Country:US
Practice Address - Phone:716-839-9290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005205-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist