Provider Demographics
NPI:1356942502
Name:MCGEADY, SHARON CLARE
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:CLARE
Last Name:MCGEADY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 GARBOSKI RD
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08559-1925
Mailing Address - Country:US
Mailing Address - Phone:609-439-1555
Mailing Address - Fax:
Practice Address - Street 1:76 GARBOSKI RD
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:NJ
Practice Address - Zip Code:08559-1925
Practice Address - Country:US
Practice Address - Phone:609-439-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00229500225X00000X, 225XL0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision