Provider Demographics
NPI:1790248102
Name:MIRANTE, SHARON Y (APN)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:Y
Last Name:MIRANTE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:Y
Other - Last Name:CARABALLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9124 NEWKIRK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4450
Mailing Address - Country:US
Mailing Address - Phone:407-617-1887
Mailing Address - Fax:
Practice Address - Street 1:570 32ND ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2434
Practice Address - Country:US
Practice Address - Phone:201-758-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00906100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily