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General NPI Number Information
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NPI Number | 1578509253
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Entity Type | Individual
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Provider Name | SHARON LYNNE BRONNER NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 1 PENN PLZ 7TH FLOOR SUITE 725
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City | NEW YORK
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State | NY
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Zip | 10119-0002
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Country | US
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Telephone | 917-576-4483
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Fax |
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Provider Business Mailing Address
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Address Line | 928 PARKWAY PL
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City | PEEKSKILL
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State | NY
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Zip | 10566-1824
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Country | US
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Telephone | 914-841-5966
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Fax | 914-736-6776
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 365175-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | F340484-1
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License Number State | NY
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