Healthcare Provider Details

I. General information

NPI: 1992828099
Provider Name (Legal Business Name): SHARON CAROL STEIN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 STATE HIGHWAY 15 NORTH
WHARTON NJ
07885
US

IV. Provider business mailing address

48 MILLER AVE
ROCKAWAY NJ
07866-2217
US

V. Phone/Fax

Practice location:
  • Phone: 973-366-5977
  • Fax:
Mailing address:
  • Phone: 973-627-2265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOA04886
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: