Provider Demographics
NPI:1891860417
Name:SCHARF, MILDRED (NP)
Entity Type:Individual
Prefix:
First Name:MILDRED
Middle Name:
Last Name:SCHARF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:MILDRED
Other - Middle Name:
Other - Last Name:EHRENFELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:448 GRIFFING AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-3012
Mailing Address - Country:US
Mailing Address - Phone:631-369-7080
Mailing Address - Fax:
Practice Address - Street 1:448 GRIFFING AVE
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-3012
Practice Address - Country:US
Practice Address - Phone:631-909-8030
Practice Address - Fax:631-207-8353
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420078363LX0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01344783Medicaid
S47831Medicare UPIN
94V181Medicare ID - Type Unspecified