Provider Demographics
NPI:1033892435
Name:JEFFERSON, SHERON D (EDD)
Entity Type:Individual
Prefix:DR
First Name:SHERON
Middle Name:D
Last Name:JEFFERSON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 BELLEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-2904
Mailing Address - Country:US
Mailing Address - Phone:908-900-9094
Mailing Address - Fax:
Practice Address - Street 1:1426 BELLEVIEW AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-2904
Practice Address - Country:US
Practice Address - Phone:908-900-9094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No174400000XOther Service ProvidersSpecialist