Provider Demographics
NPI:1346270253
Name:JOAG, SHARON S (DPM, LSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:JOAG
Suffix:
Gender:F
Credentials:DPM, LSW
Other - Prefix:DR
Other - First Name:SHARON
Other - Middle Name:S
Other - Last Name:JOAG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:770 WOODLANE RD
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-3804
Mailing Address - Country:US
Mailing Address - Phone:609-267-5928
Mailing Address - Fax:
Practice Address - Street 1:2550 BRUNSWICK PIKE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4103
Practice Address - Country:US
Practice Address - Phone:609-396-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07122400101YM0800X
NJ25MD00283600213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V07318Medicare UPIN
NJ6231250001Medicare NSC
095528Medicare ID - Type Unspecified