Individual
DR. SHARWAN K BAGLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
99 MAIN ST, KINGS PARK, NY 11754-2706
(631) 269-5550
(631) 269-6304
Mailing address
99 MAIN ST, KINGS PARK, NY 11754-2706
(631) 269-5550
(631) 269-6304
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
127799
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418222
—
NY
Enumeration date
10/28/2005
Last updated
11/09/2009
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