Provider Demographics
NPI:1578675625
Name:SHARMA, RANITA (MD)
Entity Type:Individual
Prefix:DR
First Name:RANITA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PATERSON ST # STREET7
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1962
Mailing Address - Country:US
Mailing Address - Phone:732-235-8887
Mailing Address - Fax:
Practice Address - Street 1:277 GEORGE STREET
Practice Address - Street 2:ERIC B CHANDLER HEALTH CENTER
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901
Practice Address - Country:US
Practice Address - Phone:732-235-6733
Practice Address - Fax:732-235-6726
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06434600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7553404Medicaid
NJG66830Medicare UPIN
NJ008899BVXMedicare PIN