Provider Demographics
NPI:1174921399
Name:SHARMA, ANITA (OTR/L)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3043 JOHN F KENNEDY BLVD
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3605
Mailing Address - Country:US
Mailing Address - Phone:732-824-3993
Mailing Address - Fax:
Practice Address - Street 1:3043 JOHN F KENNEDY BLVD
Practice Address - Street 2:FLOOR 2
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3605
Practice Address - Country:US
Practice Address - Phone:732-824-3993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018364225X00000X
NJ46TR00670400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist