Provider Demographics
NPI:1992742217
Name:LI, SHERRY S (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:S
Last Name:LI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4160 MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3833
Mailing Address - Country:US
Mailing Address - Phone:347-389-3888
Mailing Address - Fax:718-889-2411
Practice Address - Street 1:4160 MAIN ST
Practice Address - Street 2:SUITE 301
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3833
Practice Address - Country:US
Practice Address - Phone:347-389-3888
Practice Address - Fax:718-889-2411
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244852207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology