Provider Demographics
NPI:1407052061
Name:SHARPE, MATTHEW CHRISTOPHER (NPP, PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:CHRISTOPHER
Last Name:SHARPE
Suffix:
Gender:M
Credentials:NPP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1577 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3914
Mailing Address - Country:US
Mailing Address - Phone:585-709-8807
Mailing Address - Fax:585-386-8071
Practice Address - Street 1:1577 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3914
Practice Address - Country:US
Practice Address - Phone:585-709-8807
Practice Address - Fax:585-386-8071
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY551188163W00000X
NY401066363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse