MEDICARE: SHARON YVONNE HACKETT A.N.P

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
1	363LA2200X	Adult Health Nurse Practitioner	F303457	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F303457	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1427232727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON YVONNE HACKETT A.N.P

Provider Business Mailing Address
First Line	:	585 SCHENECTADY AVE
Second Line	:	MANAGED CARE DEPT. - 6TH FLOOR, BLUMBERG BLDG.
City	:	BROOKLYN
State	:	NY
Zip	:	11203-1809
Country	:	US
Telephone Number	:	718-604-5469
Fax Number	:	718-604-5527

Provider Business Practice Location Address
First Line	:	585 SCHENECTADY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-1809
Country	:	US
Telephone Number	:	718-604-5521
Fax Number	:	718-604-5527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2007
Last Update Date	:	05/04/2026

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Directions to “ SHARON YVONNE HACKETT A.N.P” Practice Location

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