Provider Demographics
NPI:1104182146
Name:DIGERONIMO, SHARON (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:DIGERONIMO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 DUNDERBERG RD
Mailing Address - Street 2:
Mailing Address - City:CENTRAL VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10917-3507
Mailing Address - Country:US
Mailing Address - Phone:845-460-6400
Mailing Address - Fax:845-460-6034
Practice Address - Street 1:199 DUNDERBERG RD
Practice Address - Street 2:
Practice Address - City:CENTRAL VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10917-3507
Practice Address - Country:US
Practice Address - Phone:845-460-6400
Practice Address - Fax:845-460-6034
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22283607163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse