Provider Demographics
NPI:1700147840
Name:MCSHARRY, TERESA JOAN (MSED)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:JOAN
Last Name:MCSHARRY
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 1:166 SPRINGSTEEN AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2245
Mailing Address - Country:US
Mailing Address - Phone:917-399-7994
Mailing Address - Fax:
Practice Address - Street 1:166 SPRINGSTEEN AVE
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2245
Practice Address - Country:US
Practice Address - Phone:917-399-7994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2015-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY529081111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist