Provider Demographics
NPI:1326360629
Name:SHARMA, JAI I (RPH)
Entity Type:Individual
Prefix:
First Name:JAI
Middle Name:I
Last Name:SHARMA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-2212
Mailing Address - Country:US
Mailing Address - Phone:347-784-6018
Mailing Address - Fax:
Practice Address - Street 1:12501 101ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1411
Practice Address - Country:US
Practice Address - Phone:718-849-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-28
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY053387OtherNY STATE LICENCE