Provider Demographics
NPI:1205092442
Name:COOPERMAN, SHARON ROSE (PHD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ROSE
Last Name:COOPERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ARDMORE RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7114
Mailing Address - Country:US
Mailing Address - Phone:914-725-3846
Mailing Address - Fax:
Practice Address - Street 1:211 W 61ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7832
Practice Address - Country:US
Practice Address - Phone:212-777-5966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014149103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical