Basic Information
| Provider Information | |||||||||
| NPI: | 1194798041 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARMA | ||||||||
| FirstName: | NITYA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 WESTCHESTER AVE | ||||||||
| Address2: | 3RD FL | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106042901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146813146 | ||||||||
| FaxNumber: | 9146826403 | ||||||||
| Practice Location | |||||||||
| Address1: | 3020 WESTCHESTER AVE | ||||||||
| Address2: | 2ND FL. | ||||||||
| City: | PURCHASE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105772510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142536464 | ||||||||
| FaxNumber: | 9146826403 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2006 | ||||||||
| LastUpdateDate: | 10/15/2013 | ||||||||
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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 | 207R00000X | 221178 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 041731 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 133884168 | 01 | NY | BEECH STREET | OTHER | 133884168 | 01 | NY | 1199 | OTHER | 133884168 | 01 | NY | POMCO | OTHER | 0007835232 | 01 | NY | AETNA NON HMO | OTHER | 090AK2/090AK03 | 01 | NY | BLUE CROSS PPO | OTHER | 02172214 | 05 | NY | MEDICAID |