Provider Demographics
NPI:1316160526
Name:ADESMAN, SHARON (MS CRC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:ADESMAN
Suffix:
Gender:F
Credentials:MS CRC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:ADESMAN
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CRC
Mailing Address - Street 1:1701 LANGHORNE NEWTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-579-4910
Mailing Address - Fax:
Practice Address - Street 1:1701 LANGHORNE NEWTOWN ROAD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-579-4910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00004386103T00000X
PAPS005545L103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0477736000OtherIND BLUE CROSS PERSONAL C
1669588604OtherNPI GROUP NO
1588623359OtherNPI GROUP NO