MEDICARE: DR. SHARON KRIEGEL MEMIS PHD

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	103T00000X	Psychologist	0135431	NY

General Provider Information

NPI Number	:	1730226051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON KRIEGEL MEMIS PHD

Provider Business Mailing Address
First Line	:	3649 WILDWOOD STREET
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598
Country	:	US
Telephone Number	:	914-302-7767
Fax Number	:	914-302-7767

Provider Business Practice Location Address
First Line	:	3649 WILDWOOD STREET
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598
Country	:	US
Telephone Number	:	914-302-7767
Fax Number	:	914-302-7767

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/08/2007

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