Provider Demographics
NPI:1245307040
Name:MUHAMMAD S. SHARFUDDIN, M.D., PC
Entity type:Organization
Organization Name:MUHAMMAD S. SHARFUDDIN, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:SARWAR
Authorized Official - Last Name:SHARFUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-699-7427
Mailing Address - Street 1:109 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:514 GRAMATAN AVE
Practice Address - Street 2:P3
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-3054
Practice Address - Country:US
Practice Address - Phone:914-699-7427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205316-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG19059Medicare UPIN