Healthcare Provider Details

I. General information

NPI: 1104042530
Provider Name (Legal Business Name): SHARON J KUPFER M.S., AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 COMMERCE DR
HAUPPAUGE NY
11788-3916
US

IV. Provider business mailing address

310 EAST 14 STREET
NEW YORK NY
10003
US

V. Phone/Fax

Practice location:
  • Phone: 800-221-0188
  • Fax:
Mailing address:
  • Phone: 212-979-4340
  • Fax: 212-533-3489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1317-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number14000001532
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: