1891060935 NPI number — SHARMA PC

Table of content: (NPI 1891060935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891060935 NPI number — SHARMA PC

Organization/Personal Information

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

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:
1891060935
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5910
Provider Second Line Business Mailing Address:
S UNIVERSITY BLVD C-18, #373
Provider Business Mailing Address City Name:
GREENWOOD VILLAGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80121-7508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-588-0133
Provider Business Mailing Address Fax Number:
303-954-8185

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5828 S DRY CREEK CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENWOOD VLG
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80121-1709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-588-0133
Provider Business Practice Location Address Fax Number:
303-954-8185
Provider Enumeration Date:
03/21/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SHARMA
Authorized Official First Name:
ROHINI
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PHYSICIAN
Authorized Official Telephone Number:
303-588-0133

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X , with the licence number:  45054 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 45054 . This is a "STATE LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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