MEDICARE: DR. SHARONE BETH ORNSTEIN M.D.

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	2084P0015X	Psychosomatic Medicine Physician	150624	NY

General Provider Information

NPI Number	:	1568687119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARONE BETH ORNSTEIN M.D.

Provider Business Mailing Address
First Line	:	38 HILLSIDE AVE
Second Line	:
City	:	GLEN RIDGE
State	:	NJ
Zip	:	07028-2118
Country	:	US
Telephone Number	:	973-743-9338
Fax Number	:	973-743-9226

Provider Business Practice Location Address
First Line	:	142 W END AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-6103
Country	:	US
Telephone Number	:	212-579-6336
Fax Number	:	212-875-9273

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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