Provider Demographics
NPI:1649653122
Name:YOUNG, SHARRON (RN)
Entity type:Individual
Prefix:MR
First Name:SHARRON
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 MARNE RD
Mailing Address - Street 2:UPPER
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3612
Mailing Address - Country:US
Mailing Address - Phone:716-748-9524
Mailing Address - Fax:
Practice Address - Street 1:88 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-1308
Practice Address - Country:US
Practice Address - Phone:716-748-9524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286681164W00000X
NY732684163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse