Provider Demographics
NPI:1083610489
Name:ARAGONA, SHARON LYNN (PA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:ARAGONA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:LYNN
Other - Last Name:LITVAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:711 TROY SCHENECTADY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2442
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:
Practice Address - Street 1:14 VISTA BLVD
Practice Address - Street 2:
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-2184
Practice Address - Country:US
Practice Address - Phone:518-459-5273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005258-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02509511Medicaid
NY005258-1OtherLICENSE
NYJ400143274Medicare PIN
NY02509511Medicaid
NY33-3831Medicare ID - Type Unspecified