1982958492 NPI number — SHARON TOKARZ PA

Table of content: SHARON TOKARZ PA (NPI 1982958492)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982958492 NPI number — SHARON TOKARZ PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOKARZ
Provider First Name:
SHARON
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
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:
1982958492
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 TALCOTTVILLE RD
Provider Second Line Business Mailing Address:
STE 5
Provider Business Mailing Address City Name:
VERNON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06066-5261
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-896-1422
Provider Business Mailing Address Fax Number:
860-896-1425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2800 TAMARACK AVE
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
SOUTH WINDSOR
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06074-5539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-648-4480
Provider Business Practice Location Address Fax Number:
860-648-2132
Provider Enumeration Date:
11/06/2012

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: 363AS0400X , with the licence number:  002838 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8055 . This is a "LAST FOUR OF SOCIAL" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com