Healthcare Provider Details

I. General information

NPI: 1205753340
Provider Name (Legal Business Name): SAMREEN KIDWAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SHARON REGIONAL HEALTH EDUCATION, 740 EAST STREET
SHARON PA
16146
US

IV. Provider business mailing address

SHARON REGIONAL HEALTH EDUCATION, 740 EAST STREET
SHARON PA
16146
US

V. Phone/Fax

Practice location:
  • Phone: 724-983-3988
  • Fax: 724-983-3988
Mailing address:
  • Phone: 724-983-3988
  • Fax: 724-983-3988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: