Healthcare Provider Details

I. General information

NPI: 1457366221
Provider Name (Legal Business Name): SHERRY H SATIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 GAIR STREET
PIERMONT NY
10968-1098
US

IV. Provider business mailing address

104 GAIR STREET
PIERMONT NY
10968-1098
US

V. Phone/Fax

Practice location:
  • Phone: 845-398-3640
  • Fax: 845-398-0942
Mailing address:
  • Phone: 845-398-3640
  • Fax: 845-398-0942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberRO28992
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberRO28992-1
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: