Provider Demographics
NPI:1134399694
Name:BARNUM, SHARON LEE (DC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:LEE
Last Name:BARNUM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 ROUTE 27
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3449
Mailing Address - Country:US
Mailing Address - Phone:732-985-0700
Mailing Address - Fax:
Practice Address - Street 1:1716 ROUTE 27
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3449
Practice Address - Country:US
Practice Address - Phone:732-985-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00406300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5625904Medicaid
NJ754704ZAACOtherMEDICARE PTAN