Provider Demographics
NPI:1689626533
Name:BANK, SHARON R (FNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:R
Last Name:BANK
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:110 SOUTH BEDFORD ROAD
Mailing Address - Street 2:MOUNT KISCO MEDICAL GROUP PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-242-2930
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:111 BEDFORD ROAD
Practice Address - Street 2:MOUNT KISCO MEDICAL GROUP PC
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536
Practice Address - Country:US
Practice Address - Phone:914-232-3135
Practice Address - Fax:914-232-7588
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2010-09-28
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Provider Licenses
StateLicense IDTaxonomies
NYF334002363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02661627Medicaid
NY02661627Medicaid
NY1158G1Medicare ID - Type Unspecified