Healthcare Provider Details

I. General information

NPI: 1164353603
Provider Name (Legal Business Name): SAGAMORE MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 HOWELLS RD STE 2B
BAY SHORE NY
11706-5322
US

IV. Provider business mailing address

100 MOTOR PARKWAY SUITE LL8
HAUPPAUGE NY
11788
US

V. Phone/Fax

Practice location:
  • Phone: 631-310-5071
  • Fax: 631-248-5583
Mailing address:
  • Phone: 631-310-5071
  • Fax: 631-248-5583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMIT SHARMA
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 917-400-6184