Provider Demographics
NPI:1861739914
Name:AUTH, SHARON (LAC, LMT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:AUTH
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 5TH AVE RM 515
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6405
Mailing Address - Country:US
Mailing Address - Phone:917-676-7653
Mailing Address - Fax:
Practice Address - Street 1:250 5TH AVE RM 515
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6405
Practice Address - Country:US
Practice Address - Phone:917-676-7653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002483-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist