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General NPI Number Information
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NPI Number | 1568973139
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Entity Type | Individual
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Provider Name | NIA JANE'T SHERARD
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Gender | Female
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 140 BEACH 112TH ST
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2401
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Country | US
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Telephone | 718-525-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 CLAYTON RD
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City | VALLEY STREAM
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State | NY
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Zip | 11580-1808
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Country | US
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Telephone |
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 097379
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License Number State | NY
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