Healthcare Provider Details

I. General information

NPI: 1992394597
Provider Name (Legal Business Name): MRS. MOHANIE SHARMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MOHANIE BHAJAN FNP

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 08/23/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 MADISON AVE STE 2817
NEW YORK NY
10016-5101
US

IV. Provider business mailing address

169 MADISON AVE STE 2817
NEW YORK NY
10016-5101
US

V. Phone/Fax

Practice location:
  • Phone: 888-553-2823
  • Fax: 888-553-2823
Mailing address:
  • Phone: 888-553-2823
  • Fax: 888-553-2823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024189014
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number351869
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11024976
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0037258
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704336201
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: