Provider Demographics
NPI:1609156306
Name:FONG, SHARON (DPT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:FONG
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 1:39 MIDDLE PATENT RD
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-2805
Mailing Address - Country:US
Mailing Address - Phone:845-216-3779
Mailing Address - Fax:
Practice Address - Street 1:39 MIDDLE PATENT RD
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-2805
Practice Address - Country:US
Practice Address - Phone:845-216-3779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034075225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist