Basic Information
| Provider Information | |||||||||
| NPI: | 1003069287 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OGIN | ||||||||
| FirstName: | SHARA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 263 7TH AVE | ||||||||
| Address2: | SUTIE 2A | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112153689 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183698000 | ||||||||
| FaxNumber: | 7183698011 | ||||||||
| Practice Location | |||||||||
| Address1: | 4911 13TH AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112193135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184310073 | ||||||||
| FaxNumber: | 7184310099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2008 | ||||||||
| LastUpdateDate: | 10/31/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 014775 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.