Provider Demographics
NPI:1376801167
Name:GAROFALO, SHARON ANN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:GAROFALO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:ANN
Other - Last Name:LENNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:15 ERSKINE RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3002
Mailing Address - Country:US
Mailing Address - Phone:908-534-8775
Mailing Address - Fax:
Practice Address - Street 1:225 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-3218
Practice Address - Country:US
Practice Address - Phone:718-982-4707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2401225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist