Provider Demographics
NPI:1356482848
Name:ENDER, SHARON BARBAKOFF (DPM)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:BARBAKOFF
Last Name:ENDER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:ENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:10 JOAN CT
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1901
Mailing Address - Country:US
Mailing Address - Phone:516-364-1286
Mailing Address - Fax:516-364-8672
Practice Address - Street 1:4250 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5711
Practice Address - Country:US
Practice Address - Phone:516-520-3962
Practice Address - Fax:516-520-3972
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004203213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01070364Medicaid
NYP45671Medicare PIN
NY01070364Medicaid