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General NPI Number Information
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NPI Number | 1982953956
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Entity Type | Individual
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Provider Name | PRABIN SHARMA MD
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Gender | Male
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 07/15/2018
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Provider Practice Location Address
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Address Line | 267 GRANT ST
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City | BRIDGEPORT
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State | CT
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Zip | 06610
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Country | US
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Telephone | 203-384-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 260 ENGLE ST APT 4K
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2426
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Country | US
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Telephone | 201-417-9613
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 052810
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 052810
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License Number State | CT
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