Provider Demographics
NPI:1255648853
Name:SHARMA, AARTI K (OD)
Entity type:Individual
Prefix:
First Name:AARTI
Middle Name:K
Last Name:SHARMA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 HILLSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2936
Mailing Address - Country:US
Mailing Address - Phone:917-671-7389
Mailing Address - Fax:
Practice Address - Street 1:1038 HILLSIDE BLVD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2936
Practice Address - Country:US
Practice Address - Phone:917-671-7389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV-007531152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0328419Medicaid
NYA400037789Medicare PIN