Basic Information
| Provider Information | |||||||||
| NPI: | 1295276988 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARMA | ||||||||
| FirstName: | PRIYANKA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 169 RIVERSIDE DRIVE | ||||||||
| Address2: | CREDENTIALING DEPT AT LBC | ||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139054246 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 276-280 ROBINSON ST | ||||||||
| Address2: | |||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139041659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077222769 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2017 | ||||||||
| LastUpdateDate: | 02/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 14444 | ND | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.