Provider Demographics
NPI:1265844146
Name:SHARMA, RICHA (MD)
Entity type:Individual
Prefix:MS
First Name:RICHA
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 1:69 RACHEL VINCENT WAY
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-1460
Mailing Address - Country:US
Mailing Address - Phone:516-710-5960
Mailing Address - Fax:
Practice Address - Street 1:1781 BRUZGUL RD
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-5830
Practice Address - Country:US
Practice Address - Phone:212-404-0362
Practice Address - Fax:716-845-6699
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2024-11-21
Deactivation Date:2015-01-07
Deactivation Code:
Reactivation Date:2015-03-24
Provider Licenses
StateLicense IDTaxonomies
NY289784207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine