Provider Demographics
NPI:1801155684
Name:GILGUN, SHARON CARROZZO (RN)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:CARROZZO
Last Name:GILGUN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SQUIRE ROAD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890
Mailing Address - Country:US
Mailing Address - Phone:781-729-3232
Mailing Address - Fax:
Practice Address - Street 1:148 WARREN STREET
Practice Address - Street 2:SOUTH BAY EARLY CHILDHOOD
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852
Practice Address - Country:US
Practice Address - Phone:978-452-1763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2273903101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health