MEDICARE: DR. SHERRY MARIA RANSOM DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	N004514	NY
2	213EP1101X	Primary Podiatric Medicine Podiatrist	N004514	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P46922	OTHER	NY	EMPIRE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P2728330	OTHER	NY	OXFORD

General Provider Information

NPI Number	:	1164415493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHERRY MARIA RANSOM DPM

Provider Business Mailing Address
First Line	:	360 NORTH COLUMBUS AVE
Second Line	:	SUITE 1
City	:	MT. VERNON
State	:	NY
Zip	:	10552-2332
Country	:	US
Telephone Number	:	914-668-5296
Fax Number	:	914-668-5302

Provider Business Practice Location Address
First Line	:	360 NORTH COLUMBUS AVE
Second Line	:
City	:	MT. VERNON
State	:	NY
Zip	:	10552-2032
Country	:	US
Telephone Number	:	914-668-5296
Fax Number	:	914-668-5302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	06/12/2025

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