Provider Demographics
NPI:1356785489
Name:ITKOFF NACACHE, SHARON ILAINA (LCAT, ATR-BC)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:ILAINA
Last Name:ITKOFF NACACHE
Suffix:
Gender:F
Credentials:LCAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 MAIDEN LN FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4737
Mailing Address - Country:US
Mailing Address - Phone:646-982-9626
Mailing Address - Fax:
Practice Address - Street 1:455 FDR DR
Practice Address - Street 2:B604
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5953
Practice Address - Country:US
Practice Address - Phone:646-982-9626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001622221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist