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General NPI Number Information
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NPI Number | 1356581045
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Entity Type | Individual
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Provider Name | SHAREN BRANCH
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Gender | Female
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 1191 ROUTE 9W SUITE C2 & C3
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City | MARLBORO
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State | NY
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Zip | 12542-5421
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Country | US
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Telephone | 845-236-7838
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Fax | 877-254-0888
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Provider Business Mailing Address
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Address Line | 1191 ROUTE 9W SUITE C2 & C3
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City | MARLBORO
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State | NY
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Zip | 12542-5421
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Country | US
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Telephone | 845-236-7838
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Fax | 877-254-0888
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State | NY
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