Basic Information
Provider Information
NPI: 1124391727
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHARMA
FirstName: ANURAG
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 263 FARMINGTON AVE
Address2:  
City: FARMINGTON
State: CT
PostalCode: 060321956
CountryCode: US
TelephoneNumber: 8606792000
FaxNumber:  
Practice Location
Address1: 263 FARMINGTON AVE
Address2:  
City: FARMINGTON
State: CT
PostalCode: 060321956
CountryCode: US
TelephoneNumber: 8606792000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/14/2012
LastUpdateDate: 09/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X307089NYN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RH0000X307089NYN Allopathic & Osteopathic PhysiciansInternal MedicineHematology
207RH0003X55671CTN Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RX0202X307089NYN Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
207RH0003X307089NYY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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