Provider Demographics
NPI:1952300626
Name:MONTGOMERY, SHARON LYNN (PA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:1601 MOTOR INN DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-2420
Mailing Address - Country:US
Mailing Address - Phone:330-759-6750
Mailing Address - Fax:330-759-6755
Practice Address - Street 1:1384 OLD FREEPORT RD
Practice Address - Street 2:1A
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3129
Practice Address - Country:US
Practice Address - Phone:412-967-9220
Practice Address - Fax:412-967-9303
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2024-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA000920L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA06289H10Medicare ID - Type Unspecified