Individual
MR. SHARAD KOTHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3979 LACONIA AVE, BRONX, NY 10466-4916
(347) 442-7656
(347) 442-7049
Mailing address
3979 LACONIA AVE, BRONX, NY 10466-4916
(347) 442-7656
(347) 442-7049
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
253041
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
296265
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1310097
—
MA
Enumeration date
08/18/2009
Last updated
07/21/2022
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