Provider Demographics
NPI:1811085186
Name:MIDONECK, SHARI R (MD)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:R
Last Name:MIDONECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CENTER FOR WOMEN'S HEALTH, 425 EAST 61ST ST., 11TH FL
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-746-0373
Mailing Address - Fax:212-746-7481
Practice Address - Street 1:CENTER FOR WOMEN'S HEALTH, 425 EAST 61ST ST., 11TH FL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-746-2088
Practice Address - Fax:212-746-8163
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183408207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01506894Medicaid
NYF52337Medicare UPIN
NY49H572Medicare ID - Type Unspecified