Provider Demographics
NPI:1538104377
Name:NORTHWELL HEALTH
Entity type:Organization
Organization Name:NORTHWELL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSHIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-742-5252
Mailing Address - Street 1:300 OLD COUNTRY RD STE 31
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4112
Mailing Address - Country:US
Mailing Address - Phone:516-742-5252
Mailing Address - Fax:516-742-7623
Practice Address - Street 1:300 OLD COUNTRY RD STE 31
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4112
Practice Address - Country:US
Practice Address - Phone:516-742-5252
Practice Address - Fax:516-742-7623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE94377Medicare UPIN
NYE87388Medicare UPIN
NYWEF191Medicare PIN
NYB88733Medicare UPIN