=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780900761
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARAM C SHARMA D.M&S.P
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2010
-----------------------------------------------------
Last Update Date | 04/15/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 166 SHERBURN DR
-----------------------------------------------------
City | HAMBURG
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14075-3834
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-816-2446
-----------------------------------------------------
Fax | 716-816-2450
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 400 FOREST AVENUE BUFFALO PSYCHIATRIC CENTER
-----------------------------------------------------
City | BUFFALO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14213-1298
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-816-2446
-----------------------------------------------------
Fax | 716-816-2450
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 005462
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------