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NPI Code Detail

MEDICARE: MS. SHARON ROSE WADE LMSW

MEDICARE: MS. SHARON ROSE WADE LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker061608-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003053273
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHARON ROSE WADE LMSW
Provider Business Mailing Address
First Line : 1910 ARTHUR AVE
Second Line :
City : BRONX
State : NY
Zip : 10457-6305
Country : US
Telephone Number : 718-466-8657
Fax Number : 718-716-4885
Provider Business Practice Location Address
First Line : 1910 ARTHUR AVE
Second Line :
City : BRONX
State : NY
Zip : 10457-6305
Country : US
Telephone Number : 718-466-8657
Fax Number : 718-716-4885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2009
Last Update Date : 01/12/2009

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