Provider Demographics
NPI:1952578718
Name:SHARMA, VISHAL (MD)
Entity Type:Individual
Prefix:
First Name:VISHAL
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3998 FAIR RIDGE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2921
Mailing Address - Country:US
Mailing Address - Phone:703-295-9360
Mailing Address - Fax:703-766-9725
Practice Address - Street 1:888 OLD COUNTRY RD
Practice Address - Street 2:DEP ANESTHESIOLOGY
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4914
Practice Address - Country:US
Practice Address - Phone:516-719-3000
Practice Address - Fax:516-945-3131
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2015-03-31
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Provider Licenses
StateLicense IDTaxonomies
NY253939207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03156865Medicaid
NYP00754885OtherRAILROAD MEDICARE