Provider Demographics
NPI:1790889301
Name:DECHIARA, SHARON (MD)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:DECHIARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:CRAWFORD-DECHIARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:333 NORTH BEDFORD ROAD, SUITE 230
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3417
Mailing Address - Country:US
Mailing Address - Phone:914-752-6850
Mailing Address - Fax:
Practice Address - Street 1:333 NORTH BEDFORD ROAD, SUITE 230
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-752-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2153701174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY40L301Medicare ID - Type UnspecifiedMEDICARE #
NYH12234Medicare UPIN