Provider Demographics
NPI:1235148438
Name:ADLER, SHARON OKIN (MD)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:OKIN
Last Name:ADLER
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 1:25 NEWELL RD
Mailing Address - Street 2:STE E 32
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010
Mailing Address - Country:US
Mailing Address - Phone:860-582-8074
Mailing Address - Fax:860-583-8107
Practice Address - Street 1:25 NEWELL RD
Practice Address - Street 2:STE E 32
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010
Practice Address - Country:US
Practice Address - Phone:860-582-8074
Practice Address - Fax:860-583-8107
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028941207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001289413Medicaid
E56389Medicare UPIN
CT001289413Medicaid