Provider Demographics
NPI:1417522541
Name:SHARMA, GAURISH (MD)
Entity type:Individual
Prefix:DR
First Name:GAURISH
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 E
Mailing Address - Street 2:KITCHLU NAGAR
Mailing Address - City:LUDHIANA
Mailing Address - State:PUNJAB
Mailing Address - Zip Code:141001
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2024-07-31
Deactivation Date:2023-03-27
Deactivation Code:
Reactivation Date:2023-04-18
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT78703208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program