Healthcare Provider Details

I. General information

NPI: 1851680136
Provider Name (Legal Business Name): SHERRYL A SPENCE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 N. MAIN STREET
SPRING VALLEY NY
10977
US

IV. Provider business mailing address

728 N. MAIN STREET
SPRING VALLEY NY
10977
US

V. Phone/Fax

Practice location:
  • Phone: 845-354-9300
  • Fax: 845-354-4298
Mailing address:
  • Phone: 845-354-9300
  • Fax: 845-354-4298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number010852-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: