Healthcare Provider Details

I. General information

NPI: 1528251469
Provider Name (Legal Business Name): DR GARRY SHERMAN DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 10/27/2009
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
# 2
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number25MD00080000
License Number StateNJ

VIII. Authorized Official

Name: DR. GARRY SHERMAN
Title or Position: OWNER
Credential: MD DPM PA
Phone: 973-359-4403