Provider Demographics
NPI:1790927358
Name:MANCINI, SHARON M (RN,APN-BC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:M
Last Name:MANCINI
Suffix:
Gender:F
Credentials:RN,APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HAWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07641-1416
Mailing Address - Country:US
Mailing Address - Phone:201-385-8530
Mailing Address - Fax:
Practice Address - Street 1:216 DAYTON ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4400
Practice Address - Country:US
Practice Address - Phone:201-913-5389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-28
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00190400363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health