MEDICARE: SHARON LARCOMBE

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	225X00000X	Occupational Therapist	46TR00005000	NJ

General Provider Information

NPI Number	:	1588632228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON LARCOMBE

Provider Business Mailing Address
First Line	:	836 PARVIN MILL RD
Second Line	:
City	:	PITTSGROVE
State	:	NJ
Zip	:	08318-4002
Country	:	US
Telephone Number	:	856-455-5416
Fax Number	:

Provider Business Practice Location Address
First Line	:	1051 W SHERMAN AVE
Second Line	:
City	:	VINELAND
State	:	NJ
Zip	:	08360-6931
Country	:	US
Telephone Number	:	856-696-5656
Fax Number	:	856-696-2237

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	07/08/2007

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Directions to “ SHARON LARCOMBE ” Practice Location

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