MEDICARE: SHARON J KOHNEN 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	390200000X	Student in an Organized Health Care Education/Training Program	MT187020	PA
2	390200000X	Student in an Organized Health Care Education/Training Program	MD435667	PA
3	2084P0800X	Psychiatry Physician	MD435667	PA

General Provider Information

NPI Number	:	1841497708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON J KOHNEN M.D.

Provider Business Mailing Address
First Line	:	310 CENTRAL CITY PLZ
Second Line	:
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-6441
Country	:	US
Telephone Number	:	724-335-9883
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 CENTRAL CITY PLZ
Second Line	:
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-6441
Country	:	US
Telephone Number	:	724-335-9883
Fax Number	:

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

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	04/19/2012

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