Provider Demographics
NPI:1780977322
Name:SHERMAN, ROBERT J (LP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 DONALD PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1615
Mailing Address - Country:US
Mailing Address - Phone:718-448-4616
Mailing Address - Fax:
Practice Address - Street 1:30 DONALD PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1615
Practice Address - Country:US
Practice Address - Phone:718-448-4616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000649102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst