MEDICARE: ALISHA SHERPA

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	225X00000X	Occupational Therapist	023281-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790240166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISHA SHERPA

Provider Business Mailing Address
First Line	:	8901 31ST AVE
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11369-1749
Country	:	US
Telephone Number	:	646-359-0452
Fax Number	:

Provider Business Practice Location Address
First Line	:	660 LOUISIANA AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11239-1526
Country	:	US
Telephone Number	:	718-669-7100
Fax Number	:

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

Provider Enumeration Date	:	02/09/2019
Last Update Date	:	02/09/2019

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