Healthcare Provider Details

I. General information

NPI: 1487016754
Provider Name (Legal Business Name): SHARON SALTSBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 FEDERAL RD
BROOKFIELD CT
06804-2427
US

IV. Provider business mailing address

317 FEDERAL RD
BROOKFIELD CT
06804-2427
US

V. Phone/Fax

Practice location:
  • Phone: 203-775-7150
  • Fax:
Mailing address:
  • Phone: 203-775-7150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: