Provider Demographics
NPI:1336461920
Name:POREMBA, SHARON ANN (LPN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:POREMBA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 MILITARY RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1749
Mailing Address - Country:US
Mailing Address - Phone:716-873-6727
Mailing Address - Fax:
Practice Address - Street 1:545 MILITARY RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1749
Practice Address - Country:US
Practice Address - Phone:716-873-6727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235387164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse