1104113315 NPI number — MS. RONNI S. SHERMAN C.A.G.S. (6TH YEAR)

Table of content: MS. RONNI S. SHERMAN C.A.G.S. (6TH YEAR) (NPI 1104113315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104113315 NPI number — MS. RONNI S. SHERMAN C.A.G.S. (6TH YEAR)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHERMAN
Provider First Name:
RONNI
Provider Middle Name:
S.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
C.A.G.S. (6TH YEAR)
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104113315
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
935 MAIN ST. SUITE 303
Provider Second Line Business Mailing Address:
NEW HOPE BEHAVIORAL HEALTH
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-647-2929
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
935 MAIN STREET SUITE 303
Provider Second Line Business Practice Location Address:
NEW HOPE BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-647-2929
Provider Business Practice Location Address Fax Number:
860-647-2932
Provider Enumeration Date:
07/08/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com