Provider Demographics
NPI:1457419699
Name:CHIRBAN, SHARON A (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:A
Last Name:CHIRBAN
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 1:479 WEST STREET
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:MA
Mailing Address - Zip Code:01741
Mailing Address - Country:US
Mailing Address - Phone:781-221-0670
Mailing Address - Fax:
Practice Address - Street 1:479 WEST STREET
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:MA
Practice Address - Zip Code:01741
Practice Address - Country:US
Practice Address - Phone:781-221-0670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6775103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW05356Medicare ID - Type Unspecified