Provider Demographics
NPI:1255618013
Name:FEDER, SHERRI MADELIENE (MS, CCC S/LP)
Entity type:Individual
Prefix:MS
First Name:SHERRI
Middle Name:MADELIENE
Last Name:FEDER
Suffix:
Gender:F
Credentials:MS, CCC S/LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CEDAR RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7939
Mailing Address - Country:US
Mailing Address - Phone:631-864-2598
Mailing Address - Fax:
Practice Address - Street 1:8 CEDAR RIDGE LN
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-7939
Practice Address - Country:US
Practice Address - Phone:631-864-2598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006380-1235Z00000X, 251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist