Healthcare Provider Details

I. General information

NPI: 1285415604
Provider Name (Legal Business Name): SHERYL WASHKO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 SUMMERSET DR
WALLKILL NY
12589-4735
US

IV. Provider business mailing address

11 SUMMERSET DR
WALLKILL NY
12589-4735
US

V. Phone/Fax

Practice location:
  • Phone: 347-860-4785
  • Fax: 845-566-0979
Mailing address:
  • Phone: 347-860-4785
  • Fax: 845-566-0979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number0300224
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0300224
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: