Provider Demographics
NPI:1285688390
Name:KWAN, SHARON ROSE SARABOSING (PT)
Entity type:Individual
Prefix:MRS
First Name:SHARON ROSE
Middle Name:SARABOSING
Last Name:KWAN
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:3552 71ST ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-3941
Mailing Address - Country:US
Mailing Address - Phone:718-505-0580
Mailing Address - Fax:718-505-0580
Practice Address - Street 1:1841 BROADWAY
Practice Address - Street 2:SUITE 609
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7603
Practice Address - Country:US
Practice Address - Phone:212-262-4479
Practice Address - Fax:212-262-4487
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2012-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY027286-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist