Healthcare Provider Details

I. General information

NPI: 1942691092
Provider Name (Legal Business Name): SHARON PEART PAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 02/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 3RD AVE
NEW YORK NY
10017-2703
US

IV. Provider business mailing address

3296 HIGHPOINT CT
SNELLVILLE GEORGIA
30078
UM

V. Phone/Fax

Practice location:
  • Phone: 866-926-0035
  • Fax: 646-867-7272
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number067-R-1315
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number067-R-1315
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number067-R-1315
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number067-R-1315
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number067-R-1315
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number067-R-1315
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number067-R-1315
License Number StateGA
# 8
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number067-R-1315
License Number StateGA
# 9
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number067-R-1315
License Number StateGA
# 10
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number067-R-1315
License Number StateGA
# 11
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number067-R-1315
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: