1871334508 NPI number — KARAN VIJAYKUMAR SHARMA

Table of content: KARAN VIJAYKUMAR SHARMA (NPI 1871334508)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871334508 NPI number — KARAN VIJAYKUMAR SHARMA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHARMA
Provider First Name:
KARAN
Provider Middle Name:
VIJAYKUMAR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871334508
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
GOOD SAMARITAN UNIVERSITY HOSPITAL, ST. JOSEPH HOPSITAL
Provider Second Line Business Mailing Address:
1000 MONTAUK HIGHWAY
Provider Business Mailing Address City Name:
WEST ISLIP
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11795
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-376-4163
Provider Business Mailing Address Fax Number:
631-376-3420

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ST. JOSEPH HOSPITAL
Provider Second Line Business Practice Location Address:
4295 HEMPSTEAD TPKE
Provider Business Practice Location Address City Name:
BETHPAGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-520-2538
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/05/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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