Provider Demographics
NPI:1992311260
Name:VALENTINE, SHERRY A (SPECIAL EDUCATION)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:A
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:SPECIAL EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1937 BAY RIDGE AVE APT 3R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4546
Mailing Address - Country:US
Mailing Address - Phone:718-408-0478
Mailing Address - Fax:
Practice Address - Street 1:1937 BAY RIDGE AVE APT 3R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4546
Practice Address - Country:US
Practice Address - Phone:718-408-0478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY594381121174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY594381121Medicaid