Basic Information
| Provider Information | |||||||||
| NPI: | 1033129234 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARAN | ||||||||
| FirstName: | KANU | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FEDERAL ST # 200 | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563564924 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2 COOPER PLZ | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8556322667 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 04/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | MA080563 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 2761528000 | 01 | AMERIHEALTH, KEYSTONE, IBC | OTHER | 43886 | 01 | UNIVERSITY HEALTHPLAN | OTHER | 1891985 | 01 | PA | PENSYVANIA BLUE SHIELD | OTHER | 1340402 | 01 | AETNA | OTHER | P00376176 | 01 | RR MEDICARE | OTHER | 60026412 | 01 | HORIZON NJ HEALTH | OTHER | 0114189 | 05 | NJ | MEDICAID | 1178995 | 01 | CIGNA | OTHER | 2736090 | 01 | UNITED HEALTHCARE | OTHER | 3K5929 | 01 | HEALTHNET | OTHER | P3722720 | 01 | OXFORD | OTHER |