Provider Demographics
NPI:1003069287
Name:OGIN, SHARA
Entity Type:Individual
Prefix:
First Name:SHARA
Middle Name:
Last Name:OGIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 7TH AVE
Mailing Address - Street 2:SUTIE 2A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3689
Mailing Address - Country:US
Mailing Address - Phone:718-369-8000
Mailing Address - Fax:718-369-8011
Practice Address - Street 1:4911 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3135
Practice Address - Country:US
Practice Address - Phone:718-431-0073
Practice Address - Fax:718-431-0099
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014775225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty