Provider Demographics
NPI:1942594585
Name:JOHN C. SHERSHOW, M.D., P.C.
Entity Type:Organization
Organization Name:JOHN C. SHERSHOW, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CUTLER
Authorized Official - Last Name:SHERSHOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-265-4310
Mailing Address - Street 1:240 CENTRAL PARK S
Mailing Address - Street 2:2H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1457
Mailing Address - Country:US
Mailing Address - Phone:212-265-4310
Mailing Address - Fax:516-706-0671
Practice Address - Street 1:240 CENTRAL PARK S
Practice Address - Street 2:2H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1457
Practice Address - Country:US
Practice Address - Phone:212-265-4310
Practice Address - Fax:516-706-0671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1034762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty