Provider Demographics
NPI:1205008414
Name:SHARMA, RITU (MD)
Entity Type:Individual
Prefix:DR
First Name:RITU
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
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:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:973-656-6280
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:909 RINGWOOD AVE
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:NJ
Practice Address - Zip Code:07420-1343
Practice Address - Country:US
Practice Address - Phone:973-831-6700
Practice Address - Fax:973-831-6703
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA08623500207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208000000XAllopathic & Osteopathic PhysiciansPediatrics