Healthcare Provider Details

I. General information

NPI: 1003016353
Provider Name (Legal Business Name): CORDELIA V SHARMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 11/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE SUITE 3040N
HAWTHORNE NY
10532-2140
US

IV. Provider business mailing address

972 BRUSH HOLLOW RD
WESTBURY NY
11590-1740
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-6820
  • Fax:
Mailing address:
  • Phone: 516-876-5555
  • Fax: 516-876-1246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number220174
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number220174
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: