Provider Demographics
NPI:1215293188
Name:SARKAR, SUPARNA AJOY (MBBS)
Entity type:Individual
Prefix:DR
First Name:SUPARNA
Middle Name:AJOY
Last Name:SARKAR
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:DR
Other - First Name:SUPARNA
Other - Middle Name:
Other - Last Name:HAJRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:355 BARD AVE
Mailing Address - Street 2:RICHMOND UNIVERSITY MEDICAL CENTER
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1664
Mailing Address - Country:US
Mailing Address - Phone:718-818-2424
Mailing Address - Fax:718-818-2578
Practice Address - Street 1:355 BARD AVE
Practice Address - Street 2:355 BARD AVENUE
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1664
Practice Address - Country:US
Practice Address - Phone:718-818-2424
Practice Address - Fax:718-818-2578
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281325207ZP0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program