Healthcare Provider Details

I. General information

NPI: 1962735779
Provider Name (Legal Business Name): DARLISA SHARPLESS RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DARLISA HAYES RRT

II. Dates (important events)

Enumeration Date: 09/11/2009
Last Update Date: 09/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 POLY PL RESPIRATORY CARE ROOM 13-119
BROOKLYN NY
11209-7104
US

IV. Provider business mailing address

800 POLY PL RESPIRATORY CARE ROOM 13-119
BROOKLYN NY
11209-7104
US

V. Phone/Fax

Practice location:
  • Phone: 718-836-6600
  • Fax: 718-467-5687
Mailing address:
  • Phone: 718-836-6600
  • Fax: 718-467-5687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number003020
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: