Basic Information
Provider Information
NPI: 1699064691
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHARAR
FirstName: KRISTIN
MiddleName: LYNETTE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 45 RESEARCH WAY STE 105
Address2: UNIVERSITY ASSOCIATES IN OBSTETRICS & GYNECOLOGY, UFPC
City: EAST SETAUKET
State: NY
PostalCode: 117336401
CountryCode: US
TelephoneNumber: 6316752125
FaxNumber: 6316752624
Practice Location
Address1: 320 MONTAUK HIGHWAY
Address2: UNIVERSITY ASSOCIATES IN OBSTETRICS & GYNECOLOGY, UFPC
City: WEST ISLIP
State: NY
PostalCode: 117958091
CountryCode: US
TelephoneNumber: 6315872500
FaxNumber: 6315870292
Other Information
ProviderEnumerationDate: 03/31/2011
LastUpdateDate: 06/26/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X279445-1NYY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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