Provider Demographics
NPI:1265494439
Name:GITTZUS, SHARON (ANP-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:GITTZUS
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 NORTH ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4147
Mailing Address - Country:US
Mailing Address - Phone:413-499-8510
Mailing Address - Fax:
Practice Address - Street 1:777 NORTH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4147
Practice Address - Country:US
Practice Address - Phone:413-499-8510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA182876207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA500017586OtherRAILROAD MEDICARE
MANP2516OtherBCBS
MAP252458OtherOXFORD
MANP2516Medicare ID - Type Unspecified
MAP252458OtherOXFORD