Provider Demographics
NPI:1134375058
Name:SPACE, SHARON LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LYNN
Last Name:SPACE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:565 ASHFORD CENTER RD
Mailing Address - Street 2:
Mailing Address - City:ASHFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06278-1720
Mailing Address - Country:US
Mailing Address - Phone:860-429-3444
Mailing Address - Fax:860-429-1586
Practice Address - Street 1:565 ASHFORD CENTER RD
Practice Address - Street 2:
Practice Address - City:ASHFORD
Practice Address - State:CT
Practice Address - Zip Code:06278-1720
Practice Address - Country:US
Practice Address - Phone:860-429-3444
Practice Address - Fax:860-429-1586
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0433622080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology