Healthcare Provider Details

I. General information

NPI: 1366304552
Provider Name (Legal Business Name): ROBERT SHARKEY JR. EMT-P
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 RUSSELL ST
LEWISTON ME
04240-5435
US

IV. Provider business mailing address

192 RUSSELL ST
LEWISTON ME
04240-5435
US

V. Phone/Fax

Practice location:
  • Phone: 207-777-6006
  • Fax:
Mailing address:
  • Phone: 207-777-6006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberJA18960
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: