Healthcare Provider Details

I. General information

NPI: 1285704635
Provider Name (Legal Business Name): SHARON DIAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NSUH-DEPT OF PEDIATRICS 300 COMMUNITY DRIVE
MANHASSET NY
11030
US

IV. Provider business mailing address

NSUH-DEPT OF PEDIATRICS 300 COMMUNITY DRIVE
MANHASSET NY
11030
US

V. Phone/Fax

Practice location:
  • Phone: 516-562-2542
  • Fax:
Mailing address:
  • Phone: 516-562-2542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number206353
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: