Provider Demographics
NPI:1730253022
Name:GLASSMAN, SHERRI S (PHD)
Entity type:Individual
Prefix:DR
First Name:SHERRI
Middle Name:S
Last Name:GLASSMAN
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 1:12 POTTER CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1514
Mailing Address - Country:US
Mailing Address - Phone:973-744-2412
Mailing Address - Fax:
Practice Address - Street 1:209 COOPER AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1883
Practice Address - Country:US
Practice Address - Phone:201-452-4780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ#3696103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent