Healthcare Provider Details

I. General information

NPI: 1982958492
Provider Name (Legal Business Name): SHARON TOKARZ PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2012
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 TAMARACK AVE SUITE 104
SOUTH WINDSOR CT
06074-5539
US

IV. Provider business mailing address

35 TALCOTTVILLE RD STE 5
VERNON CT
06066-5261
US

V. Phone/Fax

Practice location:
  • Phone: 860-648-4480
  • Fax: 860-648-2132
Mailing address:
  • Phone: 860-896-1422
  • Fax: 860-896-1425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number002838
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: