Provider Demographics
NPI:1275896292
Name:SHAROVETSKAYA, ANNA (DO)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:SHAROVETSKAYA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 REGENT ST
Mailing Address - Street 2:#213
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-7321
Mailing Address - Country:US
Mailing Address - Phone:917-572-2271
Mailing Address - Fax:
Practice Address - Street 1:10 REGENT ST
Practice Address - Street 2:#213
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-7321
Practice Address - Country:US
Practice Address - Phone:917-572-2271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2016-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286762207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine