Healthcare Provider Details

I. General information

NPI: 1073527347
Provider Name (Legal Business Name): SHARONE SHEFFER-BABILA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 01/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

584 FOREST AVE
STATEN ISLAND NY
10310-2512
US

IV. Provider business mailing address

1 EDGEWATER ST
STATEN ISLAND NY
10305-4907
US

V. Phone/Fax

Practice location:
  • Phone: 718-226-5619
  • Fax: 718-226-5620
Mailing address:
  • Phone: 718-226-1047
  • Fax: 718-226-1039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number240178-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number240178
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: