Healthcare Provider Details

I. General information

NPI: 1588751374
Provider Name (Legal Business Name): SHARON ANN HULBERT D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 A STATE HIGHWAY 30A
FONDA NY
12068
US

IV. Provider business mailing address

592 N GREEN RD
SPRAKERS NY
12166-3202
US

V. Phone/Fax

Practice location:
  • Phone: 518-853-1567
  • Fax: 518-853-1609
Mailing address:
  • Phone: 518-922-8624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX010120
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: