Healthcare Provider Details

I. General information

NPI: 1053678896
Provider Name (Legal Business Name): MEENAL SHARMA MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1561 LONG POND RD STE 130
ROCHESTER NY
14626
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-368-4395
  • Fax: 585-723-7735
Mailing address:
  • Phone: 585-922-0527
  • Fax: 585-922-0636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number281105
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number281105
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: