1588751374 NPI number — DR. SHARON ANN HULBERT D.C.

Table of content: DR. SHARON ANN HULBERT D.C. (NPI 1588751374)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588751374 NPI number — DR. SHARON ANN HULBERT D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HULBERT
Provider First Name:
SHARON
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588751374
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
592 N GREEN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRAKERS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12166-3202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-922-8624
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2609 A STATE HIGHWAY 30A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FONDA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-853-1567
Provider Business Practice Location Address Fax Number:
518-853-1609
Provider Enumeration Date:
10/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  X010120 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00104411 . This is a "RAIL ROAD MEDICARE PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10057726 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: C10120-6B . This is a "WORK COMP AUTHORIZATION #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: X6R72 . This is a "EMPIRE BLUE CROSS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 431905082-01 . This is a "BLUESHIELD OF NORTHEAST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: NY10120 . This is a "MVP PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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