MEDICARE: AFSANEH SHARSAN MD

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	A167930	CA
2	207R00000X	Internal Medicine Physician	64012	CT

General Provider Information

NPI Number	:	1992158125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AFSANEH SHARSAN MD

Provider Business Mailing Address
First Line	:	2035 SEAGIRT BLVD APT 5B
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-2938
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2035 SEAGIRT BLVD APT 5B
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-2938
Country	:	US
Telephone Number	:	949-973-0171
Fax Number	:

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

Provider Enumeration Date	:	07/22/2016
Last Update Date	:	12/19/2025

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