Provider Demographics
NPI:1720028723
Name:TSAI, SHERRY WOODRUFF (CPNP)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:WOODRUFF
Last Name:TSAI
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MS
Other - First Name:SHERRY
Other - Middle Name:MARGARET
Other - Last Name:TSAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPNP
Mailing Address - Street 1:129 BEACON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-1532
Mailing Address - Country:US
Mailing Address - Phone:610-996-8637
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:FEGAN 10
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-7415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN224043363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics