Provider Demographics
NPI:1396046751
Name:PILGRIM, SHERYON
Entity type:Individual
Prefix:
First Name:SHERYON
Middle Name:
Last Name:PILGRIM
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 1:5967 GREENERY VIEW LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1316
Mailing Address - Country:US
Mailing Address - Phone:702-281-9300
Mailing Address - Fax:702-220-9519
Practice Address - Street 1:1027 S RAINBOW BLVD # 276
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-6232
Practice Address - Country:US
Practice Address - Phone:702-281-9300
Practice Address - Fax:702-220-9519
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner