MEDICARE: SHARON DANE OGISTE-MCBAIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	217597	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427103241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON DANE OGISTE-MCBAIN M.D.

Provider Business Mailing Address
First Line	:	4802 CLARENDON RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5208
Country	:	US
Telephone Number	:	718-345-1420
Fax Number	:	718-451-2804

Provider Business Practice Location Address
First Line	:	5018 AVENUE D
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5906
Country	:	US
Telephone Number	:	718-451-2800
Fax Number	:	718-451-2804

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	01/16/2013

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