Provider Demographics
NPI:1184651804
Name:STARRETT, SHEREE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEREE
Middle Name:
Last Name:STARRETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 FAIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1009
Mailing Address - Country:US
Mailing Address - Phone:973-857-0543
Mailing Address - Fax:
Practice Address - Street 1:62 FAIRWAY AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1009
Practice Address - Country:US
Practice Address - Phone:973-857-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122525207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY122525OtherLICENSE NUMBER
NJMA35997OtherMEDICAL LICENSE
NYC55059Medicare UPIN
NY122525OtherLICENSE NUMBER