Provider Demographics
NPI:1497196448
Name:FIELDS, SHARI BETH
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:BETH
Last Name:FIELDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:BETH
Other - Last Name:PULIDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 STERLING PL
Mailing Address - Street 2:APT 2B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3200
Mailing Address - Country:US
Mailing Address - Phone:718-622-5674
Mailing Address - Fax:
Practice Address - Street 1:11 STERLING PL
Practice Address - Street 2:APT 2B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3200
Practice Address - Country:US
Practice Address - Phone:718-622-5674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-07
Last Update Date:2013-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY846293174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist