MEDICARE: SHARON G PLACELLA MS RN CS NPP APRN BC

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	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	2928931	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F4000751	NY
3	364S00000X	Clinical Nurse Specialist		NY

General Provider Information

NPI Number	:	1639390792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON G PLACELLA MS RN CS NPP APRN BC

Provider Business Mailing Address
First Line	:	93 JASMINE LANE
Second Line	:
City	:	EAST NORTHPORT
State	:	NY
Zip	:	11731-3617
Country	:	US
Telephone Number	:	631-266-3863
Fax Number	:

Provider Business Practice Location Address
First Line	:	554 LARKFIELD RD
Second Line	:	SUTIE 10C
City	:	EAST NORTHPORT
State	:	NY
Zip	:	11731-3617
Country	:	US
Telephone Number	:	631-368-3966
Fax Number	:

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	09/11/2025

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