Provider Demographics
NPI:1831166925
Name:STEPHEN SHERER MD PA
Entity type:Organization
Organization Name:STEPHEN SHERER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:SHERER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-945-6641
Mailing Address - Street 1:714 BERGEN BLVD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657-1425
Mailing Address - Country:US
Mailing Address - Phone:201-945-0521
Mailing Address - Fax:201-945-5604
Practice Address - Street 1:714 BERGEN BLVD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07657-1425
Practice Address - Country:US
Practice Address - Phone:201-945-0521
Practice Address - Fax:201-945-5604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37042207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0400512OtherUNITED HEALTHCARE
NJ412574OtherCIGNA
NJSS038A2710OtherEMPIRE BC/BS
NJOK2402OtherHEALTHNET
NJ0037742OtherGROUP HEALTH INC
NJ134385421OtherTRICARE
NJBS470OtherOXFORD
NJ0092076000OtherAMERIHEALTH
NJ41349OtherAETNA
NJ436208OtherCIGNA
NJ514069OtherAETNA
NJ0092076002OtherAMERIHEALTH
NJ060065908OtherRAILROAD MEDICARE
NJ1053604Medicaid
NJD96560Medicare UPIN
NJ060065908OtherRAILROAD MEDICARE