Provider Demographics
NPI:1336297423
Name:SHARMA, OLGA IRIS (MSW)
Entity Type:Individual
Prefix:MS
First Name:OLGA
Middle Name:IRIS
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:OLGA I SHARMA
Mailing Address - Street 2:1400 HELLER DR
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-3501
Mailing Address - Country:US
Mailing Address - Phone:215-493-2006
Mailing Address - Fax:215-736-3440
Practice Address - Street 1:1400 HELLER DR
Practice Address - Street 2:MAKEFIELD CHASE DEVELOPMENT
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-2745
Practice Address - Country:US
Practice Address - Phone:215-493-2006
Practice Address - Fax:215-736-3440
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000921001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0017311Medicaid