Provider Demographics
NPI:1578349734
Name:SHARMA, ANMOL (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:ANMOL
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:11537 MCGINNS TRACE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-1585
Mailing Address - Country:US
Mailing Address - Phone:980-345-9661
Mailing Address - Fax:
Practice Address - Street 1:1027 46TH AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5245
Practice Address - Country:US
Practice Address - Phone:980-345-9661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant