Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 1115831 | NY |
NPI | 1144203159 |
---|---|
Provider Name | Pradeep Sharma |
First Address | Hyde Park, NY 12538 |
Second Address | Poughkeepsie, NY 12601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2005 |
Last Update Date | 06/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00526476 | (05) | NY |