Healthcare Provider Details

I. General information

NPI: 1871670984
Provider Name (Legal Business Name): SHERILL PURCELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 FULTON ST
BROOKLYN NY
11216-2607
US

IV. Provider business mailing address

83E 38TH ST
BROOKLYN NY
11203-2006
US

V. Phone/Fax

Practice location:
  • Phone: 718-636-4500
  • Fax: 718-636-2998
Mailing address:
  • Phone: 718-778-3311
  • Fax: 718-953-1178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number175837
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: