Basic Information
Provider Information
NPI: 1033193313
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHARMA
FirstName: ANJALI
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1300 MORRIS PARK AVE
Address2: BLOCK BLDG #305
City: BRONX
State: NY
PostalCode: 104611900
CountryCode: US
TelephoneNumber: 7184302067
FaxNumber:  
Practice Location
Address1: 3444 KOSSUTH AVE
Address2: 3RD FLOOR
City: BRONX
State: NY
PostalCode: 104672410
CountryCode: US
TelephoneNumber: 7189208542
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/01/2005
LastUpdateDate: 02/25/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200X218707-1NYY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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