Healthcare Provider Details

I. General information

NPI: 1336295658
Provider Name (Legal Business Name): PERRY SHEFFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2007
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL DEPT OF PEDS, BOX 1202A
NEW YORK NY
10029-6500
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL DEPT OF PREVENTIVE MEDICINE, BOX 1057
NEW YORK NY
10029-6500
US

V. Phone/Fax

Practice location:
  • Phone: 212-659-8559
  • Fax: 212-996-9685
Mailing address:
  • Phone: 917-923-9745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number60-245958
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: