MEDICARE: SHARONE A ROSE

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	1041C0700X	Clinical Social Worker	130377-01	NY

General Provider Information

NPI Number	:	1821946088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARONE A ROSE

Provider Business Mailing Address
First Line	:	366 BROADWAY APT 1104
Second Line	:
City	:	AMITYVILLE
State	:	NY
Zip	:	11701-2788
Country	:	US
Telephone Number	:	646-239-9761
Fax Number	:

Provider Business Practice Location Address
First Line	:	727 N BROADWAY STE B1
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-2348
Country	:	US
Telephone Number	:	800-871-5491
Fax Number	:

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

Provider Enumeration Date	:	03/21/2026
Last Update Date	:	03/21/2026

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Directions to “ SHARONE A ROSE ” Practice Location

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