MEDICARE: DR. TARA LYNN SHERMAN M.D.

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	2084P0800X	Psychiatry Physician	175957	NY

General Provider Information

NPI Number	:	1497806244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARA LYNN SHERMAN M.D.

Provider Business Mailing Address
First Line	:	3671 HUDSON MANOR TER APT 17C
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-1140
Country	:	US
Telephone Number	:	212-876-0364
Fax Number	:	718-548-2908

Provider Business Practice Location Address
First Line	:	1225 PARK AVE
Second Line	:	# 1S
City	:	NEW YORK
State	:	NY
Zip	:	10128-1758
Country	:	US
Telephone Number	:	212-876-0364
Fax Number	:	718-548-2908

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	11/01/2016

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