Provider Demographics
NPI:1669733457
Name:SKELTON, SHARON (MSED)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SKELTON
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 CARROLLTON AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2916
Mailing Address - Country:US
Mailing Address - Phone:516-783-6155
Mailing Address - Fax:
Practice Address - Street 1:3350 CARROLLTON AVE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-2916
Practice Address - Country:US
Practice Address - Phone:516-783-6155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist