Provider Demographics
NPI:1518037480
Name:ANIL SHARMA PHYSICIAN PC
Entity Type:Organization
Organization Name:ANIL SHARMA PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-779-4500
Mailing Address - Street 1:35 SUNSET ROAD SOUTH
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507
Mailing Address - Country:US
Mailing Address - Phone:516-484-3139
Mailing Address - Fax:
Practice Address - Street 1:6860 AUSTIN ST
Practice Address - Street 2:303
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4220
Practice Address - Country:US
Practice Address - Phone:718-897-0008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200279207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01947740Medicaid
03700GMedicare ID - Type Unspecified
NY01947740Medicaid