Provider Demographics
NPI:1093545246
Name:MARTIN, SHARON PATRICIA (RN)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:PATRICIA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:P
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 LYNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1113
Mailing Address - Country:US
Mailing Address - Phone:516-418-1544
Mailing Address - Fax:
Practice Address - Street 1:17 LYNWOOD DR
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-1113
Practice Address - Country:US
Practice Address - Phone:516-418-1544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400491163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse