Provider Demographics
NPI:1225297047
Name:MENON, SHARIFA AMELIA (MD)
Entity Type:Individual
Prefix:
First Name:SHARIFA
Middle Name:AMELIA
Last Name:MENON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARIFA
Other - Middle Name:AMELIA
Other - Last Name:MONTEITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 E 98TH ST
Mailing Address - Street 2:BOX 1174
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6501
Mailing Address - Country:US
Mailing Address - Phone:212-241-9393
Mailing Address - Fax:212-241-4611
Practice Address - Street 1:5 E 98TH ST
Practice Address - Street 2:BOX 1174
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-241-9393
Practice Address - Fax:212-241-4611
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252802207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03158156Medicaid
NYG400009113Medicare Oscar/Certification
NYA400019937Medicare Oscar/Certification