Provider Demographics
NPI:1992800460
Name:SHARON, NADAV (MD)
Entity type:Individual
Prefix:
First Name:NADAV
Middle Name:
Last Name:SHARON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:893 COUNTY ROUTE 25
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-6009
Mailing Address - Country:US
Mailing Address - Phone:870-995-3608
Mailing Address - Fax:
Practice Address - Street 1:24 4TH ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1350
Practice Address - Country:US
Practice Address - Phone:518-481-2842
Practice Address - Fax:518-481-2843
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131525208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery