Healthcare Provider Details

I. General information

NPI: 1336585157
Provider Name (Legal Business Name): SHERIN DANIEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 05/22/2020
Certification Date: 05/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 HYLAN BLVD
STATEN ISLAND NY
10306-3117
US

IV. Provider business mailing address

2460 HYLAN BLVD
STATEN ISLAND NY
10306-3117
US

V. Phone/Fax

Practice location:
  • Phone: 718-226-5619
  • Fax: 718-226-5620
Mailing address:
  • Phone: 718-226-5619
  • Fax: 718-226-5620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number281643
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: