MEDICARE: JEREMY SAMUEL SHERMAN NP

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	363LF0000X	Family Nurse Practitioner	356025	NY

General Provider Information

NPI Number	:	1639978984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY SAMUEL SHERMAN NP

Provider Business Mailing Address
First Line	:	630 W 168TH ST STE 401
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3725
Country	:	US
Telephone Number	:	212-305-1021
Fax Number	:	212-342-5759

Provider Business Practice Location Address
First Line	:	161 FORT WASHINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3729
Country	:	US
Telephone Number	:	212-305-1021
Fax Number	:	212-342-5759

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

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	06/15/2026

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