Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N003153 | NY |
NPI | 1073501029 |
---|---|
Provider Name | Dr. Richard Sherman |
First Address | Floral Park, NY 11001-2100 |
Second Address | Floral Park, NY 11001-2100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 20/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T32110 | (02) | NY |