Healthcare Provider Details

I. General information

NPI: 1699740506
Provider Name (Legal Business Name): WILLIAM SHERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MANETTO HILL RD SUITE 306
PLAINVIEW NY
11803-1311
US

IV. Provider business mailing address

2800 MARCUS AVE
NEW HYDE PARK NY
11042-1113
US

V. Phone/Fax

Practice location:
  • Phone: 516-933-1088
  • Fax: 516-933-6279
Mailing address:
  • Phone: 516-622-6000
  • Fax: 516-608-2889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number152623
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: