Provider Demographics
NPI:1922443852
Name:WHEELER, SHARON LEE (MT-BC, LCAT, HTTP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LEE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MT-BC, LCAT, HTTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-9724
Mailing Address - Country:US
Mailing Address - Phone:407-718-7707
Mailing Address - Fax:
Practice Address - Street 1:17 HOLLAND DR
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-9724
Practice Address - Country:US
Practice Address - Phone:407-718-7707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000866282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital