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General NPI Number Information
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NPI Number | 1336459858
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Entity Type | Individual
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Provider Name | SHARON MARIE GOLD OTR
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Gender | Female
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 75 PARK STREET
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City | ELIZABETHTOWN
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State | NY
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Zip | 12932
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Country | US
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Telephone | 518-873-3017
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 625 8 COBBLE HILL LANE
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City | ELIZABETHTOWN
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State | NY
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Zip | 12932-0625
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Country | US
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Telephone | 518-873-9909
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 001764-1
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License Number State | NY
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