Basic Information
| Provider Information | |||||||||
| NPI: | 1932357563 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARP | ||||||||
| FirstName: | DARYL | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD, NPP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 ELMWOOD AVE | ||||||||
| Address2: | BOX SON | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146420001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852756465 | ||||||||
| FaxNumber: | 5852731270 | ||||||||
| Practice Location | |||||||||
| Address1: | 1655 ELMWOOD AVE | ||||||||
| Address2: | SUITE 125 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146203429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855302050 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2008 | ||||||||
| LastUpdateDate: | 09/08/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | F400689-1 | NY | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.