Provider Demographics
NPI:1902068083
Name:SHARMA, ASHLESHA (DO)
Entity Type:Individual
Prefix:
First Name:ASHLESHA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4408 COCHRANE PKWY
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-7702
Mailing Address - Country:US
Mailing Address - Phone:530-229-4467
Mailing Address - Fax:
Practice Address - Street 1:315 S MANNING BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1707
Practice Address - Country:US
Practice Address - Phone:518-525-1401
Practice Address - Fax:518-525-1200
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2023-01-19
Deactivation Date:2015-08-27
Deactivation Code:
Reactivation Date:2016-07-05
Provider Licenses
StateLicense IDTaxonomies
IADO-046332085R0202X
NY2962792085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology