Individual
MRS. SHARLENE WILLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP, PMHNP
Contact information
Practice address
15905 UNION TPKE, FRESH MEADOWS, NY 11366-1950
(718) 906-6700
(718) 906-6805
Mailing address
15905 UNION TPKE, FRESH MEADOWS, NY 11366-1950
(718) 906-6700
(718) 906-6801
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
335707
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403425
NY
Other
Enumeration date
03/13/2009
Last updated
07/07/2021
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