Basic Information
| Provider Information | |||||||||
| NPI: | 1891071510 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHERMAN | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1987 STATE ROUTE 52 | ||||||||
| Address2: | SUITE 11 | ||||||||
| City: | LIBERTY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 127548316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8452928580 | ||||||||
| FaxNumber: | 8452928909 | ||||||||
| Practice Location | |||||||||
| Address1: | 1987 STATE ROUTE 52 | ||||||||
| Address2: | SUITE 11 | ||||||||
| City: | LIBERTY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 127548316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8452928580 | ||||||||
| FaxNumber: | 8452928909 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2011 | ||||||||
| LastUpdateDate: | 01/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 034186-1 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.