Healthcare Provider Details

I. General information

NPI: 1922761113
Provider Name (Legal Business Name): AIDAN T SHARMA DOCTOR OF AUDIOLOGY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8817 BELAIR RD STE 105
NOTTINGHAM MD
21236-2445
US

IV. Provider business mailing address

851 BROKEN SOUND PKWY NW STE 120
BOCA RATON FL
33487-3638
US

V. Phone/Fax

Practice location:
  • Phone: 104-444-4420
  • Fax: 561-299-5438
Mailing address:
  • Phone: 561-367-1623
  • Fax: 561-299-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01575
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: