Provider Demographics
NPI:1053069823
Name:ROME, SHARON SADAYA (PNP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:SADAYA
Last Name:ROME
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SENECA PL
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1412
Mailing Address - Country:US
Mailing Address - Phone:516-987-7029
Mailing Address - Fax:
Practice Address - Street 1:21 SENECA PL
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1412
Practice Address - Country:US
Practice Address - Phone:516-987-7029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381740-01363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics