Provider Demographics
NPI:1578772752
Name:SHERMAN PEDIATRICS CARE PLLC
Entity Type:Organization
Organization Name:SHERMAN PEDIATRICS CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:B
Authorized Official - Last Name:VILLEGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-404-9086
Mailing Address - Street 1:9320 ROOSEVELT AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7944
Mailing Address - Country:US
Mailing Address - Phone:718-404-9086
Mailing Address - Fax:877-634-1286
Practice Address - Street 1:4312 43RD ST
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-2608
Practice Address - Country:US
Practice Address - Phone:718-355-9780
Practice Address - Fax:718-355-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care