Provider Demographics
NPI:1588751374
Name:HULBERT, SHARON ANN (DC)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ANN
Last Name:HULBERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:592 N GREEN RD
Mailing Address - Street 2:
Mailing Address - City:SPRAKERS
Mailing Address - State:NY
Mailing Address - Zip Code:12166-3202
Mailing Address - Country:US
Mailing Address - Phone:518-922-8624
Mailing Address - Fax:
Practice Address - Street 1:2609 A STATE HIGHWAY 30A
Practice Address - Street 2:
Practice Address - City:FONDA
Practice Address - State:NY
Practice Address - Zip Code:12068
Practice Address - Country:US
Practice Address - Phone:518-853-1567
Practice Address - Fax:518-853-1609
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010120111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00104411OtherRAIL ROAD MEDICARE PIN
NY10057726OtherCDPHP
NYC10120-6BOtherWORK COMP AUTHORIZATION #
NYX6R72OtherEMPIRE BLUE CROSS
NY431905082-01OtherBLUESHIELD OF NORTHEAST
NYNY10120OtherMVP PROVIDER NUMBER
NY10057726OtherCDPHP
NYU82205Medicare UPIN