Provider Demographics
NPI:1386893196
Name:CORITSIDIS, SHARON G (RN, MSN, CPNP, CPON)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:G
Last Name:CORITSIDIS
Suffix:
Gender:F
Credentials:RN, MSN, CPNP, CPON
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 STATION PLZ N
Mailing Address - Street 2:SUITE 611
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3800
Mailing Address - Country:US
Mailing Address - Phone:516-663-2532
Mailing Address - Fax:516-663-8874
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 460
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4064
Practice Address - Country:US
Practice Address - Phone:516-663-9400
Practice Address - Fax:516-663-9482
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381497-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics