Provider Demographics
NPI:1801006069
Name:SHARMA, ISHITA (MD)
Entity Type:Individual
Prefix:
First Name:ISHITA
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 1:1275 YORK AVE
Mailing Address - Street 2:MEMORIAL SLOAN KETTERING CANCER CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:646-888-3194
Mailing Address - Fax:646-422-0937
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:MEMORIAL SLOAN KETTERING CANCER CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:646-888-3194
Practice Address - Fax:646-422-0937
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA07812Medicaid