MEDICARE: DR. ALIDA CAROL SHERMAN PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	013118-1	NY

General Provider Information

NPI Number	:	1396952750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALIDA CAROL SHERMAN PSY.D.

Provider Business Mailing Address
First Line	:	1 MEADOW DR
Second Line	:	APT 1L
City	:	WOODMERE
State	:	NY
Zip	:	11598-2204
Country	:	US
Telephone Number	:	516-791-2928
Fax Number	:	516-791-2928

Provider Business Practice Location Address
First Line	:	1226 W BROADWAY
Second Line	:
City	:	HEWLETT
State	:	NY
Zip	:	11557-1923
Country	:	US
Telephone Number	:	516-398-9782
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	08/25/2020

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