MEDICARE: DR. KRISHNA SHARMA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	200562-1	NY
2	208D00000X	General Practice Physician	200562-1	NY

General Provider Information

NPI Number	:	1497715809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISHNA SHARMA

Provider Business Mailing Address
First Line	:	400 FORT HILL AVE
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-1159
Country	:	US
Telephone Number	:	585-393-7268
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 FORT HILL AVE
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-1159
Country	:	US
Telephone Number	:	585-393-7268
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	05/28/2021

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