Provider Demographics
NPI:1164001574
Name:TERGINO, SHERRI (CRNA, MS)
Entity type:Individual
Prefix:MS
First Name:SHERRI
Middle Name:
Last Name:TERGINO
Suffix:
Gender:F
Credentials:CRNA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 2ND ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4440
Mailing Address - Country:US
Mailing Address - Phone:516-902-4595
Mailing Address - Fax:
Practice Address - Street 1:53 2ND ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4440
Practice Address - Country:US
Practice Address - Phone:516-902-4595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-04
Last Update Date:2021-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124221367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered