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General NPI Number Information
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NPI Number | 1811247562
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Entity Type | Individual
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Provider Name | SHARON E LUBERTO PT
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Gender | Female
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 74 OAK ST
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-2557
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Country | US
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Telephone | 201-857-3860
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Fax |
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Provider Business Mailing Address
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Address Line | 34 DONNA LN
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City | MIDLAND PARK
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State | NJ
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Zip | 07432-1212
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Country | US
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Telephone | 201-251-9359
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA0052525400
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License Number State | NJ
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