Provider Demographics
NPI:1710291034
Name:KOHN, SHERRY (NP)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:
Last Name:KOHN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5141 BROADWAY
Mailing Address - Street 2:ROOM 3-005
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1159
Mailing Address - Country:US
Mailing Address - Phone:212-932-5190
Mailing Address - Fax:212-932-5081
Practice Address - Street 1:5141 BROADWAY
Practice Address - Street 2:ROOM 3-005
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1159
Practice Address - Country:US
Practice Address - Phone:212-932-5190
Practice Address - Fax:212-932-5081
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305302363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health