Provider Demographics
NPI:1558800201
Name:SHARMA, SUKIRTI (MS, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:SUKIRTI
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:SUKIRTI
Other - Middle Name:
Other - Last Name:SHAH/PARIKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:25734 RAWLEY SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-5741
Mailing Address - Country:US
Mailing Address - Phone:703-856-2416
Mailing Address - Fax:703-894-2888
Practice Address - Street 1:25734 RAWLEY SPRINGS DR
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-5741
Practice Address - Country:US
Practice Address - Phone:703-856-2416
Practice Address - Fax:703-894-2888
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-14
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD01787133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered