Provider Demographics
NPI:1396952750
Name:SHERMAN, ALIDA CAROL (PSYD)
Entity type:Individual
Prefix:DR
First Name:ALIDA
Middle Name:CAROL
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEADOW DR
Mailing Address - Street 2:APT 1L
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2204
Mailing Address - Country:US
Mailing Address - Phone:516-791-2928
Mailing Address - Fax:516-791-2928
Practice Address - Street 1:1226 W BROADWAY
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1923
Practice Address - Country:US
Practice Address - Phone:516-398-9782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013118-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
V82281Medicare ID - Type Unspecified