Healthcare Provider Details

I. General information

NPI: 1346270253
Provider Name (Legal Business Name): SHARON S JOAG DPM, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON S JOAG DPM

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 BRUNSWICK PIKE
LAWRENCEVILLE NJ
08648-4103
US

IV. Provider business mailing address

770 WOODLANE RD
WESTAMPTON NJ
08060-3804
US

V. Phone/Fax

Practice location:
  • Phone: 609-396-8877
  • Fax:
Mailing address:
  • Phone: 609-267-5928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number44SL07122400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00283600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: