Provider Demographics
NPI:1841231073
Name:NERI, SHARENE ANTOINETTE (RDMS RVT RDCS RT)
Entity Type:Individual
Prefix:MS
First Name:SHARENE
Middle Name:ANTOINETTE
Last Name:NERI
Suffix:
Gender:F
Credentials:RDMS RVT RDCS RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 W MAPLE TREE DR
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-9600
Mailing Address - Country:US
Mailing Address - Phone:609-267-0916
Mailing Address - Fax:619-267-9441
Practice Address - Street 1:640 NORTH WHITEHORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037
Practice Address - Country:US
Practice Address - Phone:609-567-9003
Practice Address - Fax:609-567-9269
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ237502471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA094626Medicare ID - Type Unspecified