Provider Demographics
NPI:1154973048
Name:HALL, SHARON ANTOINETTE
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ANTOINETTE
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 PELHAM BAY PARK W APT 1F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-1030
Mailing Address - Country:US
Mailing Address - Phone:347-932-5324
Mailing Address - Fax:
Practice Address - Street 1:2552 PELHAM BAY PARK WEST, APT 1 D
Practice Address - Street 2:2551 PELHAM BAY PARK WEST
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475
Practice Address - Country:US
Practice Address - Phone:347-932-5324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY726919163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse