MEDICARE: DR. SHEREEN RAMPERSAD DPT

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	225100000X	Physical Therapist	034726	NY

General Provider Information

NPI Number	:	1629342597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEREEN RAMPERSAD DPT

Provider Business Mailing Address
First Line	:	PO BOX 1210
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-0536
Country	:	US
Telephone Number	:	631-432-2241
Fax Number	:	888-485-7175

Provider Business Practice Location Address
First Line	:	340 HOWELLS RD
Second Line	:	SUITE B
City	:	BAY SHORE
State	:	NY
Zip	:	11706-5322
Country	:	US
Telephone Number	:	631-432-2241
Fax Number	:	888-485-7175

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

Provider Enumeration Date	:	02/24/2012
Last Update Date	:	05/02/2014

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