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General NPI Number Information
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NPI Number | 1760331979
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Entity Type | Individual
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Provider Name | JITENDRA SHARMA
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Gender | Male
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Dates
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Enumeration Date | 01/22/2026
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 12328 NATURAL BRIDGE RD
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City | BRIDGETON
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State | MO
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Zip | 63044-2019
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Country | US
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Telephone | 314-429-5136
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Fax |
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Provider Business Mailing Address
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Address Line | 71 FOUNTAINVIEW DR
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City | SAINT CHARLES
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State | MO
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Zip | 63303-3048
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Country | US
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Telephone | 407-924-5513
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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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | MO
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