Provider Demographics
NPI:1720295454
Name:NATHAN, SHARON G (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:G
Last Name:NATHAN
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 1:155 W 70TH ST APT 6H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4421
Mailing Address - Country:US
Mailing Address - Phone:212-724-6507
Mailing Address - Fax:212-877-7660
Practice Address - Street 1:155 W 70TH ST APT 6H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4421
Practice Address - Country:US
Practice Address - Phone:212-724-6507
Practice Address - Fax:212-877-7660
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6053103T00000X
NYPSYCHOLOGIY 6053103TB0200X
NYPSYCHOLOGY 6053103TC0700X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth