Provider Demographics
NPI:1629215033
Name:BERLA, SHERRY (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:
Last Name:BERLA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:ROSENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1230 CAFFREY AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5249
Mailing Address - Country:US
Mailing Address - Phone:610-955-4092
Mailing Address - Fax:
Practice Address - Street 1:1230 CAFFREY AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5249
Practice Address - Country:US
Practice Address - Phone:610-955-4092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029459-1225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist