Provider Demographics
NPI:1871865436
Name:GUTMAN, SHARON A (PHD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:A
Last Name:GUTMAN
Suffix:
Gender:F
Credentials:PHD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HORIZON RD
Mailing Address - Street 2:APT. 1007
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6652
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 HORIZON RD
Practice Address - Street 2:APT. 1007
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6652
Practice Address - Country:US
Practice Address - Phone:201-777-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-29
Last Update Date:2012-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006145-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist