Provider Demographics
NPI:1396105946
Name:DONGELEWIC, SHARON (MS)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:DONGELEWIC
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HUNTLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:LOUDONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12211-1156
Mailing Address - Country:US
Mailing Address - Phone:518-269-0263
Mailing Address - Fax:
Practice Address - Street 1:12 HUNTLEIGH DR
Practice Address - Street 2:
Practice Address - City:LOUDONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12211-1156
Practice Address - Country:US
Practice Address - Phone:518-269-0263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY855152141174400000X
NY855222141174400000X
NY1004861161174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist