Healthcare Provider Details

I. General information

NPI: 1003681958
Provider Name (Legal Business Name): SHERMIN KOH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2023
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 S BROADWAY STE 504
WHITE PLAINS NY
10601-4429
US

IV. Provider business mailing address

475 S JEFFERSON ST APT 102
ORANGE NJ
07050-1273
US

V. Phone/Fax

Practice location:
  • Phone: 914-454-2505
  • Fax:
Mailing address:
  • Phone: 323-565-5504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF407114
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: