Provider Demographics
NPI:1124230198
Name:KAY, SHARON LOIS (NPP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LOIS
Last Name:KAY
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:LOIS
Other - Last Name:KOZAKIEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NPP
Mailing Address - Street 1:57 MINER RD
Mailing Address - Street 2:
Mailing Address - City:PORTER CORNERS
Mailing Address - State:NY
Mailing Address - Zip Code:12859-1702
Mailing Address - Country:US
Mailing Address - Phone:518-584-3600
Mailing Address - Fax:518-581-2535
Practice Address - Street 1:30 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-5142
Practice Address - Country:US
Practice Address - Phone:518-584-3600
Practice Address - Fax:518-581-2535
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400623363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health