Provider Demographics
NPI:1851312490
Name:GEORGE, SHERIN (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERIN
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SHERIN
Other - Middle Name:
Other - Last Name:VARGHESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:924 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3628
Mailing Address - Country:US
Mailing Address - Phone:516-354-4242
Mailing Address - Fax:516-354-7788
Practice Address - Street 1:918 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3637
Practice Address - Country:US
Practice Address - Phone:516-354-4242
Practice Address - Fax:516-354-4242
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV-006797152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02601756Medicaid
NYV08550Medicare UPIN
NYCCWER1Medicare PIN