Provider Demographics
NPI:1497252985
Name:SHARMA, ROHAN
Entity Type:Individual
Prefix:MR
First Name:ROHAN
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 1:48 LOUIS DR
Mailing Address - Street 2:
Mailing Address - City:S FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3232
Mailing Address - Country:US
Mailing Address - Phone:516-603-0245
Mailing Address - Fax:
Practice Address - Street 1:225 BROADHOLLOW RD STE 402
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4899
Practice Address - Country:US
Practice Address - Phone:516-385-7780
Practice Address - Fax:516-385-7795
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician