Provider Demographics
NPI:1447569801
Name:RECORE, SHARON LYNN
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:RECORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PICKETTS CORNERS
Mailing Address - Street 2:
Mailing Address - City:SARANAC
Mailing Address - State:NY
Mailing Address - Zip Code:12981
Mailing Address - Country:US
Mailing Address - Phone:518-565-5900
Mailing Address - Fax:518-565-5890
Practice Address - Street 1:18 PICKETTS CORNERS
Practice Address - Street 2:
Practice Address - City:SARANAC
Practice Address - State:NY
Practice Address - Zip Code:12981
Practice Address - Country:US
Practice Address - Phone:518-565-5900
Practice Address - Fax:518-565-5890
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0121052251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics