MEDICARE: DR. ROBERT BRETT SHERRY D.C.

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	111NR0400X	Rehabilitation Chiropractor	2674	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA3306	OTHER	MA	HARVARD PILGRIM HEALTH CA
2	1120356	OTHER	MA	AETNA
3	8724026001	OTHER	MA	CIGNA
4	Y36983	OTHER	MA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1942429915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT BRETT SHERRY D.C.

Provider Business Mailing Address
First Line	:	1551 BLUE HILL AVE
Second Line	:
City	:	MATTAPAN
State	:	MA
Zip	:	02126-2122
Country	:	US
Telephone Number	:	617-298-3200
Fax Number	:	617-298-3233

Provider Business Practice Location Address
First Line	:	1551 BLUE HILL AVE
Second Line	:
City	:	MATTAPAN
State	:	MA
Zip	:	02126-2122
Country	:	US
Telephone Number	:	617-298-3200
Fax Number	:	617-298-3233

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

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	01/24/2012

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