Provider Demographics
NPI:1235157389
Name:SHARMA, RAKESH
Entity Type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 S FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2550
Mailing Address - Country:US
Mailing Address - Phone:201-785-8899
Mailing Address - Fax:201-785-8869
Practice Address - Street 1:27 S FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2550
Practice Address - Country:US
Practice Address - Phone:201-785-8899
Practice Address - Fax:201-785-8869
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO64071174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7612702Medicaid
NJG75096Medicare UPIN
NJ7612702Medicaid