MEDICARE: SHARON AMY EMMER

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	363LP2300X	Primary Care Nurse Practitioner	307807	NY

General Provider Information

NPI Number	:	1649722042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON AMY EMMER

Provider Business Mailing Address
First Line	:	1616 COURT NORTH DR
Second Line	:
City	:	MELVILLE
State	:	NY
Zip	:	11747-8142
Country	:	US
Telephone Number	:	631-375-5734
Fax Number	:

Provider Business Practice Location Address
First Line	:	1616 COURT NORTH DR
Second Line	:
City	:	MELVILLE
State	:	NY
Zip	:	11747-8142
Country	:	US
Telephone Number	:	631-375-5734
Fax Number	:

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

Provider Enumeration Date	:	11/01/2016
Last Update Date	:	11/01/2016

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Directions to “ SHARON AMY EMMER ” Practice Location

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