Provider Demographics
NPI:1902872211
Name:SHARMA, PARVESH K (MD)
Entity Type:Individual
Prefix:DR
First Name:PARVESH
Middle Name:K
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GRIST MILL CT
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-2914
Mailing Address - Country:US
Mailing Address - Phone:917-684-4185
Mailing Address - Fax:
Practice Address - Street 1:55 OLD NYACK TPKE
Practice Address - Street 2:SUITE 601
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2461
Practice Address - Country:US
Practice Address - Phone:917-684-4185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229703-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300035075OtherMEDICARE ID
NY02558661Medicaid
NYA300035075OtherMEDICARE ID
I00061Medicare UPIN