=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326452046
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHARDE HARVEY, DDS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2014
-----------------------------------------------------
Last Update Date | 06/20/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 121 E 60TH ST SUITE 1B
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10022-1117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-697-1701
-----------------------------------------------------
Fax | 212-755-2747
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 121 E 60TH ST SUITE 1B
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10022-1117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-697-1701
-----------------------------------------------------
Fax | 212-755-2747
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SHARDE HARVEY
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 212-697-1701
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 051418
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------