Basic Information
| Provider Information | |||||||||
| NPI: | 1184234643 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECKFORD | ||||||||
| FirstName: | SHERRAINE | ||||||||
| MiddleName: | CLEOPATRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 WATER STREET | ||||||||
| Address2: | 2ND FLOOR CRED DEPT | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100410010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6466802888 | ||||||||
| FaxNumber: | 5165425556 | ||||||||
| Practice Location | |||||||||
| Address1: | 88-31 55TH AVENUE, SUITE 201 | ||||||||
| Address2: | |||||||||
| City: | ELMHURST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113734686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188996600 | ||||||||
| FaxNumber: | 7186063881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2020 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 11007640 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 363LF0000X | F349306 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.