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General NPI Number Information
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NPI Number | 1053658195
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Entity Type | Individual
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Provider Name | MARIANNE SHARKO M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/09/2013
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 369 E 148TH ST
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City | BRONX
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State | NY
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Zip | 10455-4041
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Country | US
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Telephone | 718-769-2698
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Fax |
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Provider Business Mailing Address
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Address Line | 4 PALLISER RD
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City | IRVINGTON
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State | NY
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Zip | 10533-2019
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Country | US
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Telephone | 914-674-2285
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 205750-1
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License Number State | NY
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