Provider Demographics
NPI:1942351838
Name:SENIOR, SHARON DAWN (FNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:DAWN
Last Name:SENIOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 JARRET PL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2606
Mailing Address - Country:US
Mailing Address - Phone:718-862-8849
Mailing Address - Fax:718-862-8851
Practice Address - Street 1:1521 JARRET PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2606
Practice Address - Country:US
Practice Address - Phone:718-862-8849
Practice Address - Fax:718-862-8851
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0387088363LF0000X
NY334229363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04126936Medicaid