Provider Demographics
NPI:1780223263
Name:ZEOLI, SHARON JOY (NP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:JOY
Last Name:ZEOLI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-6116
Mailing Address - Country:US
Mailing Address - Phone:631-678-1763
Mailing Address - Fax:
Practice Address - Street 1:895 W JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3229
Practice Address - Country:US
Practice Address - Phone:631-982-2022
Practice Address - Fax:631-982-2024
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309285363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner