Healthcare Provider Details

I. General information

NPI: 1043941297
Provider Name (Legal Business Name): RESET KIDNEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 WOODMERE BLVD STE C4
MONTGOMERY AL
36106-3083
US

IV. Provider business mailing address

PO BOX 2270
EDISON NJ
08818-2270
US

V. Phone/Fax

Practice location:
  • Phone: 412-880-9378
  • Fax:
Mailing address:
  • Phone: 412-880-9378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ARUN SHARMA
Title or Position: CEO
Credential: OWNER
Phone: 412-880-9378