Healthcare Provider Details

I. General information

NPI: 1790351724
Provider Name (Legal Business Name): VATSALA SHARMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 1ST AVE
NEW YORK NY
10029-7491
US

IV. Provider business mailing address

1901 1ST AVE
NEW YORK NY
10029-7491
US

V. Phone/Fax

Practice location:
  • Phone: 844-692-4692
  • Fax:
Mailing address:
  • Phone: 844-692-4692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number336538
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: