Provider Demographics
NPI:1629080759
Name:PRINGLE, SHERYL R (MD)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:R
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:161 COMMON WEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:MT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552
Mailing Address - Country:US
Mailing Address - Phone:718-467-7200
Mailing Address - Fax:718-467-4064
Practice Address - Street 1:1669 BEDFORD AVE
Practice Address - Street 2:ASTRO CARE MEDICAL CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225
Practice Address - Country:US
Practice Address - Phone:718-467-7200
Practice Address - Fax:718-467-7064
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY198962-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01590078Medicaid
NY01590078Medicaid
G22048Medicare UPIN