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General NPI Number Information
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NPI Number | 1720440100
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Entity Type | Individual
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Provider Name | MR. CHETAN SHARMA
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Gender | Male
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 400 POST AVENUE SUITE 203
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City | WESTBURY
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State | NY
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Zip | 11590
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Country | US
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Telephone | 516-501-9500
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Fax | 516-501-9501
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Provider Business Mailing Address
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Address Line | 75 WOODCREST DRIVE
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City | MUTTONTOWN
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State | NY
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Zip | 11791
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Country | US
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Telephone | 516-333-4109
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Fax | 516-501-9501
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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