Healthcare Provider Details

I. General information

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

II. Dates (important events)

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

III. Provider practice location address

506 LENOX AVENUE HARLEM HOSPITAL CENTER: DEPARTMENT OF PEDIATRICS MLK 17
NEW YORK NY
10037
US

IV. Provider business mailing address

506 LENOX AVENUE HARLEM HOSPITAL CENTER: DEPARTMENT OF PEDIATRICS MLK 17
NEW YORK NY
10037
US

V. Phone/Fax

Practice location:
  • Phone: 212-939-4019
  • Fax:
Mailing address:
  • Phone: 212-939-4019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: