MEDICARE: SHERRY SHAHRZAD NAZARIAN D.P.M. P.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	213ES0131X	Foot Surgery Podiatrist	N005761	NY

General Provider Information

NPI Number	:	1982836334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERRY SHAHRZAD NAZARIAN D.P.M. P.C.

Provider Business Mailing Address
First Line	:	2266 E 64TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-6314
Country	:	US
Telephone Number	:	718-444-8151
Fax Number	:	718-363-6647

Provider Business Practice Location Address
First Line	:	2083 E 53RD PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4710
Country	:	US
Telephone Number	:	718-258-2500
Fax Number	:	718-865-5112

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. SHAHRZAD SHERRY NAZARIAN
Credential	:	D.P.M.
Telephone Number	:	718-207-8256

Provider Enumeration Date	:	08/19/2009
Last Update Date	:	03/28/2012

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