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NPI Code Detail

MEDICARE: MS. PAVAN REKHA SHARMA MS., RD., CDE

MEDICARE: MS. PAVAN REKHA SHARMA MS., RD., CDE
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
1133VN1006XMetabolic Nutrition Registered Dietitian860319NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15530864OTHERNJCIGNA HEALTH CARE
23724244OTHERNJHMO
37964646OTHERNJAETNA
4P3465920OTHERNJOXFORD HEALTH CARE PLAN

General Provider Information

NPI Number : 1497848493
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PAVAN REKHA SHARMA MS., RD., CDE
Provider Business Mailing Address
First Line : 9 BAKLEY TER
Second Line :
City : WEST ORANGE
State : NJ
Zip : 07052-2169
Country : US
Telephone Number : 739-715-1630
Fax Number :
Provider Business Practice Location Address
First Line : 271 GROVE AVE
Second Line : STE A
City : VERONA
State : NJ
Zip : 07044-1731
Country : US
Telephone Number : 973-239-2600
Fax Number : 973-239-0482
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 09/26/2023

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