Provider Demographics
NPI:1780767657
Name:SHERR, ALAN P (DC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:P
Last Name:SHERR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 FORT SALONGA RD
Mailing Address - Street 2:25A
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768
Mailing Address - Country:US
Mailing Address - Phone:631-262-8505
Mailing Address - Fax:631-754-2909
Practice Address - Street 1:220 FORT SALONGA RD
Practice Address - Street 2:25A
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768
Practice Address - Country:US
Practice Address - Phone:631-262-8505
Practice Address - Fax:631-754-2909
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2546111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X14311Medicare PIN