Provider Demographics
NPI:1801102405
Name:CHROSTOWSKI, SHARON A (LSCW)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:A
Last Name:CHROSTOWSKI
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 552
Mailing Address - Street 2:6176 MCLAIN ROAD
Mailing Address - City:ORISKANY FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13425-0552
Mailing Address - Country:US
Mailing Address - Phone:315-821-6207
Mailing Address - Fax:
Practice Address - Street 1:227 W DOMINICK ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-5853
Practice Address - Country:US
Practice Address - Phone:315-336-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730718601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical