Provider Demographics
NPI:1043660921
Name:ST. HILLAIRE, SHARON (DPT)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:ST. HILLAIRE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 HUNTER PL
Mailing Address - Street 2:STE. 101
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-3940
Mailing Address - Country:US
Mailing Address - Phone:516-458-9376
Mailing Address - Fax:540-720-5660
Practice Address - Street 1:382 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3115
Practice Address - Country:US
Practice Address - Phone:203-250-9663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210302225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist