Provider Demographics
NPI:1457499063
Name:REMALY, SHARON R (NCTMB)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:R
Last Name:REMALY
Suffix:
Gender:F
Credentials:NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 BAY ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3512
Mailing Address - Country:US
Mailing Address - Phone:651-283-8438
Mailing Address - Fax:
Practice Address - Street 1:653 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3401
Practice Address - Country:US
Practice Address - Phone:651-222-8517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist