Provider Demographics
NPI:1730688276
Name:HIGGINS, SHARON BERNADETTE (RDN)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:BERNADETTE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4272 HUNTER ST
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4118
Mailing Address - Country:US
Mailing Address - Phone:917-833-4048
Mailing Address - Fax:
Practice Address - Street 1:4272 HUNTER ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4118
Practice Address - Country:US
Practice Address - Phone:917-833-4048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-11
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86075734133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered