Provider Demographics
NPI:1629102074
Name:SHER, MALVINA (BS PT)
Entity Type:Individual
Prefix:
First Name:MALVINA
Middle Name:
Last Name:SHER
Suffix:
Gender:F
Credentials:BS PT
Other - Prefix:
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Mailing Address - Street 1:379 KINGS HIGHWAY
Mailing Address - Street 2:#3A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223
Mailing Address - Country:US
Mailing Address - Phone:646-696-5804
Mailing Address - Fax:
Practice Address - Street 1:525 EAST 68 STREET
Practice Address - Street 2:142A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-746-1483
Practice Address - Fax:212-746-1611
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY023760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist