Provider Demographics
NPI:1780853721
Name:ANIL K. SHARMA, MD, PA
Entity Type:Organization
Organization Name:ANIL K. SHARMA, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-473-0025
Mailing Address - Street 1:3 PLAZA DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08757-3759
Mailing Address - Country:US
Mailing Address - Phone:732-473-0025
Mailing Address - Fax:732-473-0087
Practice Address - Street 1:3 PLAZA DR
Practice Address - Street 2:SUITE 4
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757-3759
Practice Address - Country:US
Practice Address - Phone:732-473-0025
Practice Address - Fax:732-473-0087
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANIL K. SHARMA MD, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07174200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8718709Medicaid
052827Medicare PIN