| Doctor Name: | DR. SHARWAN K BAGLA |
| NPI Number: | 1043201189 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 127799 |
| Business Practice Address: | 99 Main St Kings Park, NY - 117542706 |
| Business Phone Number: | 6312695550 |
| Business Fax Number: | 6312696304 |
| Mailing Address: | 99 Main St, KINGS PARK |
| State: | NY |
| Postal Code: | 117542706 |
| Phone Number: | 6312695550 |
| Fax Number: | 6312696304 |
| NPI Enumeration Date: | 10/28/2005 |
| NPI Last Update Date: | 11/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RA0000X |
| License Number: | 127799 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |