Healthcare Provider Details

I. General information

NPI: 1568995819
Provider Name (Legal Business Name): REBECCA SHARMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9120 ATLANTIC AVE
OZONE PARK NY
11416-1527
US

IV. Provider business mailing address

8900 VAN WYCK EXPRESSWAY JAMAICA HOSPITAL
RICHMOND HILL NY
11418
US

V. Phone/Fax

Practice location:
  • Phone: 718-641-8207
  • Fax:
Mailing address:
  • Phone: 718-206-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number305701
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number305701
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: