Provider Demographics
NPI:1730263393
Name:SHERMAN, FREDERIC (MD)
Entity type:Individual
Prefix:
First Name:FREDERIC
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BARKER AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1524
Mailing Address - Country:US
Mailing Address - Phone:914-949-1199
Mailing Address - Fax:914-517-2682
Practice Address - Street 1:3 BARKER AVE FL 4
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1524
Practice Address - Country:US
Practice Address - Phone:914-949-1199
Practice Address - Fax:914-517-2682
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117136207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01750792Medicaid
A62128Medicare UPIN
NY01750792Medicaid