Basic Information
Provider Information
NPI: 1003003880
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHARMA
FirstName: MADHU
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 55 N BROWNING AVE
Address2:  
City: TENAFLY
State: NJ
PostalCode: 076701912
CountryCode: US
TelephoneNumber: 2012666822
FaxNumber:  
Practice Location
Address1: 111 E 210TH ST
Address2: MONTEFIORE MEDICAL CENTER
City: BRONX
State: NY
PostalCode: 104672401
CountryCode: US
TelephoneNumber: 7187412538
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/26/2007
LastUpdateDate: 09/12/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X254441NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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