Provider Demographics
NPI:1740338235
Name:RASA, SHARON LEE (DC)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LEE
Last Name:RASA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3691
Mailing Address - Country:US
Mailing Address - Phone:908-534-2166
Mailing Address - Fax:908-534-2688
Practice Address - Street 1:109 MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889-3691
Practice Address - Country:US
Practice Address - Phone:908-534-2166
Practice Address - Fax:908-534-2688
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00586200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38MC00586200OtherCHIROPRACTIC LICENSE