Provider Demographics
NPI:1922081629
Name:SHERMAN, ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 N PARK AVE
Mailing Address - Street 2:SUITE#205
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4100
Mailing Address - Country:US
Mailing Address - Phone:516-764-0904
Mailing Address - Fax:516-365-0656
Practice Address - Street 1:53 N PARK AVE
Practice Address - Street 2:SUITE#205
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4100
Practice Address - Country:US
Practice Address - Phone:516-764-0904
Practice Address - Fax:516-365-0656
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1999522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G22042Medicare UPIN