Healthcare Provider Details

I. General information

NPI: 1447229463
Provider Name (Legal Business Name): GARRY SHERMAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MADISON AVE B2
MORRISTOWN NJ
07960
US

IV. Provider business mailing address

101 MADISON AVE B2
MORRISTOWN NJ
07960
US

V. Phone/Fax

Practice location:
  • Phone: 973-359-4403
  • Fax: 973-898-7311
Mailing address:
  • Phone: 973-359-4403
  • Fax: 973-898-7311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00080000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: