Provider Demographics
NPI:1447690888
Name:SHERMAN, MELISSA LAUREN (OD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:LAUREN
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:LAUREN
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:30 E 40TH ST RM 203
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1248
Mailing Address - Country:US
Mailing Address - Phone:212-889-3550
Mailing Address - Fax:
Practice Address - Street 1:30 E 40TH ST RM 203
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1248
Practice Address - Country:US
Practice Address - Phone:212-889-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-30
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007983-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist