Provider Demographics
NPI:1295891364
Name:SERMIER, MARTHA ACKERMAN
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:ACKERMAN
Last Name:SERMIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:A
Other - Last Name:SERMIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CS
Mailing Address - Street 1:2 5TH AVE APT 19G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8842
Mailing Address - Country:US
Mailing Address - Phone:212-982-1258
Mailing Address - Fax:
Practice Address - Street 1:31 WASHINGTON SQ W
Practice Address - Street 2:# 6F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9126
Practice Address - Country:US
Practice Address - Phone:212-260-9496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333511101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health