Provider Demographics
NPI:1790351724
Name:SHARMA, VATSALA
Entity Type:Individual
Prefix:
First Name:VATSALA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79-01 BROADWAY, DEPARTMENT OF PSYCHIATRY, NYC HEALTH &
Mailing Address - Street 2:
Mailing Address - City:ELMHURST NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11372
Mailing Address - Country:US
Mailing Address - Phone:718-334-3542
Mailing Address - Fax:718-334-3441
Practice Address - Street 1:79-01 BROADWAY
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY, ELMHURST HOSPITAL CENTER
Practice Address - City:ELMHURST NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-334-3268
Practice Address - Fax:718-334-3441
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program