Individual provider Active NPI

Sharlini Bissram

  • Specialist
  • Staten Island, NY
National Provider Identifier
1255770830
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
573199111 Issued in NY
Practice address
390 Grimsby St
Staten Island, NY 10306-5830
Phone
(646) 642-7585
NPI assigned
Jun 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 573199111 NY Primary

Addresses

Primary practice location

390 Grimsby St
Staten Island, NY 10306-5830

Mailing address

390 Grimsby St
Staten Island, NY 10306-5830
Phone (646) 642-7585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
573199111NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1255770830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 GRIMSBY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065830",
            "telephone_number": "646-642-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 GRIMSBY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065830",
            "telephone_number": "646-642-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSRAM",
        "first_name": "SHARLINI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "573199111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.