Healthcare Provider Details

I. General information

NPI: 1275560856
Provider Name (Legal Business Name): SHARON EMERGENCY MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 HOSPITAL HILL DRIVE ER DEPARTMENT
SHARON CT
06069
US

IV. Provider business mailing address

PO BOX 753
LAKEVILLE CT
06039
US

V. Phone/Fax

Practice location:
  • Phone: 800-795-5820
  • Fax: 616-975-9728
Mailing address:
  • Phone: 866-898-7138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR CHIN
Title or Position: PHYSICIAN
Credential: MD
Phone: 860-364-4141