Doctor Name: | SHARON A KANDRO |
NPI Number: | 1528181716 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 002294 |
Business Practice Address: | 1 Royce Cir Suite 104 Storrs, CT - 062682260 |
Business Phone Number: | 8604879200 |
Business Fax Number: | 8604879222 |
Mailing Address: | 263 Farmington Ave, Provider Enrollment FARMINGTON |
State: | CT |
Postal Code: | 060302212 |
Phone Number: | 8606797503 |
Fax Number: | 8606791610 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 12/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 002294 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |