Healthcare Provider Details

I. General information

NPI: 1467444935
Provider Name (Legal Business Name): USHA SHARMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 09/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HOY AVE
FORDS NJ
08863-1920
US

IV. Provider business mailing address

30 HOY AVE
FORDS NJ
08863-1920
US

V. Phone/Fax

Practice location:
  • Phone: 732-225-9115
  • Fax: 732-225-2814
Mailing address:
  • Phone: 732-225-9115
  • Fax: 732-225-2814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA32788
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: