Provider Demographics
NPI:1235505959
Name:JOSEPH, SHERIN (MA, RD, CDN)
Entity type:Individual
Prefix:MS
First Name:SHERIN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:
Credentials:MA, RD, CDN
Other - Prefix:
Other - First Name:SHERIN
Other - Middle Name:
Other - Last Name:JACOB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, RD, CDN
Mailing Address - Street 1:137 ALEXANDER ST APT 2319
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5092
Mailing Address - Country:US
Mailing Address - Phone:832-283-7530
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:832-283-7530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2025-04-16
Deactivation Date:2016-04-07
Deactivation Code:
Reactivation Date:2025-03-21
Provider Licenses
StateLicense IDTaxonomies
NY009155-01133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered