Provider Demographics
NPI:1053064535
Name:SHARON DIRECT CARE PLLC
Entity Type:Organization
Organization Name:SHARON DIRECT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TZVI
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUESTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-806-0467
Mailing Address - Street 1:12 BILLINGS ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2120
Mailing Address - Country:US
Mailing Address - Phone:781-806-0467
Mailing Address - Fax:781-732-6897
Practice Address - Street 1:12A BILLINGS ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-2120
Practice Address - Country:US
Practice Address - Phone:781-806-0467
Practice Address - Fax:781-732-6897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty