Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | F420157 | NY |
Y | 363LW0102X | Nurse Practitioner - Women's Health | F420157 | NY |
NPI | 1063494821 |
---|---|
Provider Name | Deborah Sherman |
First Address | Middletown, NY 10941-4028 |
Second Address | Middletown, NY 10941-7001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 08/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02681996 | (05) | NY |