Provider Demographics
NPI:1912218512
Name:TERRELONGE, SHARON (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:TERRELONGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CLARENDON DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2503
Mailing Address - Country:US
Mailing Address - Phone:516-376-4467
Mailing Address - Fax:
Practice Address - Street 1:33 CLARENDON DR
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2503
Practice Address - Country:US
Practice Address - Phone:516-376-4467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5487671163WS0200X
NY338375363LF0000X
NY548767-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No163W00000XNursing Service ProvidersRegistered Nurse