Provider Demographics
NPI:1558502146
Name:GOLDSTEIN, SHARON (MSOTR/L)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 E 14TH ST
Mailing Address - Street 2:APT 1D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7162
Mailing Address - Country:US
Mailing Address - Phone:347-922-5532
Mailing Address - Fax:
Practice Address - Street 1:1565 E 14TH ST
Practice Address - Street 2:APT 1D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7162
Practice Address - Country:US
Practice Address - Phone:347-922-5532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011174-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics