Provider Demographics
NPI:1649350257
Name:SHERMAN, HOWARD ALLEN (OD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:ALLEN
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 RARITAN AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2446
Mailing Address - Country:US
Mailing Address - Phone:732-247-1167
Mailing Address - Fax:866-811-3770
Practice Address - Street 1:202 RARITAN AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2446
Practice Address - Country:US
Practice Address - Phone:732-247-1167
Practice Address - Fax:866-811-3770
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2010-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00428300152WP0200X, 152WS0006X, 152WC0802X, 152WV0400X
NJ27TO00132900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6799205Medicaid
T49010Medicare UPIN
823236Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID #