Provider Demographics
NPI:1801053939
Name:GUADAGNO, SHARON
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:GUADAGNO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:GUADAGNO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:15 WHEELER PL W
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 WHEELER PL W
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2908
Practice Address - Country:US
Practice Address - Phone:914-309-1492
Practice Address - Fax:845-535-5614
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC07813500163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator