Provider Demographics
NPI:1679915508
Name:SHAROBEEM, MARK
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:SHAROBEEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MOLLY PITCHER RD
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2443
Mailing Address - Country:US
Mailing Address - Phone:917-692-6408
Mailing Address - Fax:
Practice Address - Street 1:30 BROAD ST STE 401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-4110
Practice Address - Country:US
Practice Address - Phone:917-692-6408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY89599213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery