Provider Demographics
NPI:1487612982
Name:SHERMAN, RANDI SALLE (PHD)
Entity type:Individual
Prefix:DR
First Name:RANDI
Middle Name:SALLE
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 HUNGERFORD RD N
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1363
Mailing Address - Country:US
Mailing Address - Phone:914-432-5852
Mailing Address - Fax:
Practice Address - Street 1:144 HUNGERFORD RD N
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1363
Practice Address - Country:US
Practice Address - Phone:914-432-5852
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY90289OtherAETNA
NY4899814OtherGHI
NYM01291OtherBLUE CROSS
NY3C0253OtherHEALTH NET - MULTI-PLAN
NY20 58 34 20 03OtherCIGNA
NY01801725Medicaid
NY90289OtherUS HEALTHCARE
NY20 58 34 20 03OtherCIGNA