Provider Demographics
NPI:1568719581
Name:SHARMA, SURINDRA SAINI
Entity Type:Individual
Prefix:MS
First Name:SURINDRA
Middle Name:SAINI
Last Name:SHARMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SURINDRA
Other - Middle Name:
Other - Last Name:SAINI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:15813 72ND AVE
Mailing Address - Street 2:# 7C
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4100
Mailing Address - Country:US
Mailing Address - Phone:718-969-5729
Mailing Address - Fax:
Practice Address - Street 1:15813 72ND AVE
Practice Address - Street 2:# 7C
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11365-4100
Practice Address - Country:US
Practice Address - Phone:718-969-5729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF 337196364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health