Provider Demographics
NPI:1285066704
Name:SHAMAH, SHARON LENORE (SPECIAL EDUCATOR)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LENORE
Last Name:SHAMAH
Suffix:
Gender:F
Credentials:SPECIAL EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5817
Mailing Address - Country:US
Mailing Address - Phone:718-664-5991
Mailing Address - Fax:
Practice Address - Street 1:328 E 62ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8206
Practice Address - Country:US
Practice Address - Phone:212-752-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY26453OtherNYSDOH