Provider Demographics
NPI:1578590337
Name:HERRMANN, CHERYL A (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:HERRMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1340
Mailing Address - Country:US
Mailing Address - Phone:585-426-1290
Mailing Address - Fax:585-426-2597
Practice Address - Street 1:2870 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-1340
Practice Address - Country:US
Practice Address - Phone:585-426-1290
Practice Address - Fax:585-426-2597
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235573207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2355733WCFPOtherWORKERS COMP
NY02680115Medicaid
NY02680115Medicaid
NYRA7606-GRP:70008AMedicare PIN
NYJ400076523Medicare PIN
NYRA7607- GRP:BA0017Medicare PIN
I37205Medicare UPIN