Basic Information
| Provider Information | |||||||||
| NPI: | 1487612982 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHERMAN | ||||||||
| FirstName: | RANDI | ||||||||
| MiddleName: | SALLE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 144 HUNGERFORD RD N | ||||||||
| Address2: | |||||||||
| City: | BRIARCLIFF MANOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105101363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144325852 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 144 HUNGERFORD RD N | ||||||||
| Address2: | |||||||||
| City: | BRIARCLIFF MANOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105101363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144325852 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 204 | NY | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 90289 | 01 | NY | AETNA | OTHER | 4899814 | 01 | NY | GHI | OTHER | M01291 | 01 | NY | BLUE CROSS | OTHER | 3C0253 | 01 | NY | HEALTH NET - MULTI-PLAN | OTHER | 20 58 34 20 03 | 01 | NY | CIGNA | OTHER | 01801725 | 05 | NY | MEDICAID | 90289 | 01 | NY | US HEALTHCARE | OTHER |