Healthcare Provider Details

I. General information

NPI: 1578711214
Provider Name (Legal Business Name): NEELAM SHARMA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2008
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 KINNELON RD STE K
KINNELON NJ
07405-2337
US

IV. Provider business mailing address

1250 DRIVING PARK AVE
NEWARK NY
14513-1057
US

V. Phone/Fax

Practice location:
  • Phone: 201-416-4346
  • Fax:
Mailing address:
  • Phone: 315-332-2427
  • Fax: 315-335-2324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number003528
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: