Provider Demographics
NPI:1063743854
Name:GILMOUR, SHERINE E
Entity type:Individual
Prefix:MS
First Name:SHERINE
Middle Name:E
Last Name:GILMOUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 4TH AVE
Mailing Address - Street 2:APT. D3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-1151
Mailing Address - Country:US
Mailing Address - Phone:347-461-2557
Mailing Address - Fax:
Practice Address - Street 1:220 5TH AVE
Practice Address - Street 2:SUITE 802
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7708
Practice Address - Country:US
Practice Address - Phone:347-461-2557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000686102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst