Healthcare Provider Details

I. General information

NPI: 1265542666
Provider Name (Legal Business Name): SHERRI E PUTTERMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 OLD COUNTRY RD SUITE650
MINEOLA NY
11501-4235
US

IV. Provider business mailing address

200 OLD COUNTRY RD SUITE650
MINEOLA NY
11501-4235
US

V. Phone/Fax

Practice location:
  • Phone: 516-747-0105
  • Fax: 516-280-2612
Mailing address:
  • Phone: 516-747-0105
  • Fax: 516-280-2612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number216561
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: