Provider Demographics
NPI:1922116797
Name:SHERMAN, SPENCER E (MD)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:E
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 1:166 E 63RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7636
Mailing Address - Country:US
Mailing Address - Phone:212-753-8300
Mailing Address - Fax:212-752-4285
Practice Address - Street 1:166 E 63RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7636
Practice Address - Country:US
Practice Address - Phone:212-753-8300
Practice Address - Fax:212-752-4285
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093722207W00000X
NJ21054207W00000X
FL20030207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D47424Medicare UPIN
NYW99821Medicare PIN