Provider Demographics
NPI:1184685349
Name:BURATOWSKI, SHARON ANN ZAJAC (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN ZAJAC
Last Name:BURATOWSKI
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301WEST MARKHAM
Mailing Address - Street 2:SLOT 547-11
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7199
Mailing Address - Country:US
Mailing Address - Phone:501-686-6102
Mailing Address - Fax:501-296-1216
Practice Address - Street 1:4301 W MARKHAM ST
Practice Address - Street 2:SLOT 547-11
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-6102
Practice Address - Fax:501-296-1216
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR174225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR670001880OtherPALMETTO RAILROAD MCARE
AR142914721Medicaid
AR7891261OtherAETNA
AR7108572485OtherQUAL CHOICE
AR5T848OtherBCBS
AR5T848OtherBLUE CROSS BLUE SHIELD
AR670001880OtherPALMETTO RAILROAD MCARE
AR670001880Medicare UPIN
AR5T848Medicare UPIN