Healthcare Provider Details

I. General information

NPI: 1861066045
Provider Name (Legal Business Name): SHERI-DAWN CUNNINGHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date: 09/26/2022
Reactivation Date: 10/06/2022

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1197
US

IV. Provider business mailing address

1400 PELHAM PKWY S
BRONX NY
10461-1197
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-5000
  • Fax:
Mailing address:
  • Phone: 718-918-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number332792
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: