Provider Demographics
NPI:1558422964
Name:SHARMA, PUSHPENDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:PUSHPENDRA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 NEW HYDE PARK RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3210
Mailing Address - Country:US
Mailing Address - Phone:718-850-0972
Mailing Address - Fax:
Practice Address - Street 1:1660 NEW HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3210
Practice Address - Country:US
Practice Address - Phone:718-850-0972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88479207RG0300X
NY229666207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine