Provider Demographics
NPI:1720053853
Name:SHARLOW, JOAN G (RPAC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:G
Last Name:SHARLOW
Suffix:
Gender:F
Credentials:RPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 NEW SCOTLAND AVE MC157
Mailing Address - Street 2:THE VASCULAR GROUP PLLC
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-262-5640
Mailing Address - Fax:518-262-5110
Practice Address - Street 1:43 NEW SCOTLAND AVE MC157
Practice Address - Street 2:THE VASCULAR GROUP PLLC
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:518-262-5640
Practice Address - Fax:518-262-5110
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003204363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0256335Medicaid
NY0256335Medicaid
PA0700Medicare ID - Type Unspecified