Provider Demographics
NPI:1497848493
Name:SHARMA, PAVAN REKHA (MS, RD, CDE)
Entity Type:Individual
Prefix:MS
First Name:PAVAN
Middle Name:REKHA
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MS, RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BAKLEY TER
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2169
Mailing Address - Country:US
Mailing Address - Phone:739-715-1630
Mailing Address - Fax:
Practice Address - Street 1:271 GROVE AVE
Practice Address - Street 2:STE A
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1731
Practice Address - Country:US
Practice Address - Phone:973-239-2600
Practice Address - Fax:973-239-0482
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ860319133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5530864OtherCIGNA HEALTH CARE
NJ3724244OtherHMO
NJ7964646OtherAETNA
NJP3465920OtherOXFORD HEALTH CARE PLAN
NJ5530864OtherCIGNA HEALTH CARE