MEDICARE: MICHAEL P SHARAK PA

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	363AM0700X	Medical Physician Assistant	000439	NY

General Provider Information

NPI Number	:	1992702278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL P SHARAK PA

Provider Business Mailing Address
First Line	:	750 E ADAMS ST
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13210-2306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	90 PRESIDENTIAL PLZ
Second Line	:	FIRM B
City	:	SYRACUSE
State	:	NY
Zip	:	13202-2240
Country	:	US
Telephone Number	:	315-464-5412
Fax Number	:

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	06/22/2009

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Directions to “ MICHAEL P SHARAK PA” Practice Location

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