Individual
SHARON BUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 686-7648
(631) 476-2791
Mailing address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 686-7648
(631) 476-2791
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000639-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000639-1
CERTIFICATION NUMBER
NY
Enumeration date
10/15/2014
Last updated
10/15/2014
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