Provider Demographics
NPI:1265871081
Name:AL-HARK, SHAREEDAH ZAYEEDAH (LPN, DOULA)
Entity type:Individual
Prefix:MS
First Name:SHAREEDAH
Middle Name:ZAYEEDAH
Last Name:AL-HARK
Suffix:
Gender:F
Credentials:LPN, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 HUTCHINSON AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-2242
Mailing Address - Country:US
Mailing Address - Phone:623-308-6382
Mailing Address - Fax:
Practice Address - Street 1:219 HUTCHINSON AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-2242
Practice Address - Country:US
Practice Address - Phone:623-308-6382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305502164W00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No164W00000XNursing Service ProvidersLicensed Practical Nurse