Provider Demographics
NPI:1992394597
Name:SHARMA, MOHANIE
Entity type:Individual
Prefix:MRS
First Name:MOHANIE
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MOHANIE
Other - Middle Name:
Other - Last Name:BHAJAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:169 MADISON AVE STE 2817
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5101
Mailing Address - Country:US
Mailing Address - Phone:888-553-2823
Mailing Address - Fax:888-553-2823
Practice Address - Street 1:169 MADISON AVE STE 2817
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5101
Practice Address - Country:US
Practice Address - Phone:888-553-2823
Practice Address - Fax:888-553-2823
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189014363LF0000X
NY351869363LF0000X
FLAPRN11024976363LF0000X
OHAPRN.CNP.0037258363LF0000X
MI4704336201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1992394597Medicaid
FL122473300Medicaid
VA30017833600001Medicaid