Provider Demographics
NPI:1780609388
Name:KESDEN, SHERRY H (MD)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:H
Last Name:KESDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:865 MERRICK AVENUE
Mailing Address - Street 2:SUITE 80N
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590
Mailing Address - Country:US
Mailing Address - Phone:516-804-5200
Mailing Address - Fax:516-240-6540
Practice Address - Street 1:649 BROADWAY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-2313
Practice Address - Country:US
Practice Address - Phone:516-798-1411
Practice Address - Fax:516-798-0362
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY134728207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00668680Medicaid
NYA400100371Medicare PIN
NYB16081Medicare UPIN