DR. JACK KEVIN SHARP (NPI# 1104880079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104880079 |
| Entity Type | Individual |
| Full Name | DR. JACK KEVIN SHARP |
| Credential | MD |
| Practice Address |
219 Bryant Street Buffalo NY 14222-2006 |
| Mailing Address |
4511 Harlem Rd Suite 202 Amherst NY 14226-3822 |
| Practice Telephone | 7168787524 |
| Practice Fax Number | 7168883945 |
| Mailing Telephone | 7168396720 |
| Mailing Fax Number | 7168396740 |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2009-12-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
216985 | NY | Allopathic & Osteopathic Physicians |
| N | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
216985-1 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UNIVERA | 00021037301 | 01 | |
| BC/BS | 000525957001 | 01 | |
| PA | 001819708001 | 05 | |
| NY | 02062031 | 05 | |
| FIDELIS | 040426001868 | 01 | |
| IHA | 4410946 | 01 |
| Street Address |
219 BRYANT STREET |
| City | BUFFALO |
| State | NY |
| Zip Code | 14222-2006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114915287 | Lynne Marie Fries | Physician Assistant | 219 Bryant Street, Buffalo, NY 14222-2006 | 2005-10-12 |
| 1730619768 | Andrea Fatima D'mello | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Buffalo, NY 14222 | 2017-06-13 |
| 1285169953 | Jackelyn Lau | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Buffalo, NY 14222 | 2017-05-01 |
| 1114450335 | Zaheer Cheema | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Women and Children Hospital, Buffalo, NY 14222 | 2017-04-05 |
| 1053767780 | Traci Punturiero | Dietitian, Registered | 219 Bryant Street, Buffalo, NY 14222-2006 | 2016-05-12 |
| 1265888523 | Viveka Clare De Guerra | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Women & Children's Hospital of Buffalo, Buffalo, NY 14222 | 2016-05-05 |
| 1225415714 | Rim Elchaki | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Women & Children's Hospital of Buffalo, Buffalo, NY 14222 | 2015-05-04 |
| 1114312840 | Mallory Scogin | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Dept. of Obgyn, University At Buffalo, Buffalo, NY 14222 | 2015-03-31 |
| 1518300342 | Rabheh Abdul Aziz | Pediatrics | 219 Bryant Street, Buffalo, NY 14222-2006 | 2013-04-11 |
| 1992019558 | Natasha Gill | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Women & Children's Hospital of Buffalo, Buffalo, NY 14222 | 2010-08-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407414360 | Brittany Marie Dorsey | Registered Nurse | 770 W. Ferry St, Apt 25b, Buffalo, NY 14222 | 2019-06-04 |
| 1215495494 | Tina Colaizzo-anas | Dietitian, Registered | 214 Caudell Hall, 1300 Elmwood Avenue, Buffalo, NY 14222 | 2019-03-07 |
| 1558831560 | Nichole Virag | Doula | 195 Lexington Ave, E, Buffalo, NY 14222 | 2018-12-03 |
| 1487120234 | Lakieta L Smith | Massage Therapist | 820 Elmwood Ave, 5, Buffalo, NY 14222 | 2018-10-19 |
| 1235524646 | Ann Caughill | Registered Nurse | 257 Elmwood Ave., Room 303, Buffalo, NY 14222 | 2015-04-02 |
| 1255608535 | Vinay Sharma | Pediatrics | 239 Bryant Street, Division of Neonatology, Buffalo, NY 14222 | 2011-11-30 |
| 1558644757 | John Arthur Gillespie | Internal Medicine | 190 Bryant St., Buffalo, NY 14222 | 2011-09-23 |
| 1861773384 | Pamela Mary Sheehan-schreck | Nurse Practitioner | 239 Bryant St., 2nd Floor, Buffalo, NY 14222 | 2011-08-30 |
| 1295025286 | Jeanie Bowen Hayes | Specialist/Technologist | 90 Highland Avenue, Buffalo, NY 14222 | 2011-04-12 |
| 1649404260 | Colleen Ann Nugent | Pediatrics | 239 Bryant Str, Women and Children's Hospital of Buffalo, Buffalo, NY 14222 | 2009-05-11 |
| Find all providers in zip 14222 | ||||
| Taxonomy Code | 2080P0214X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Pulmonology |
| A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255618906 | Geovanny Francisco Perez Estrella | Pediatrics | 1001 Main St Fl 4, Buffalo, NY 14203-1009 | 2011-11-09 |
| 1902989783 | Jamie L Wooldridge | Pediatrics | 1001 Main St Fl 4, Buffalo, NY 14203-1009 | 2006-10-23 |
| 1881777225 | Daniel William Sheehan | Pediatrics | 219 Bryant St, Buffalo, NY 14222-2006 | 2006-10-21 |
| 1770515033 | Kaleida Health | Pediatrics | 219 Bryant St, Buffalo, NY 14222-2006 | 2006-07-07 |
| 1861457848 | Drucy Sarette Borowitz | Pediatrics | 219 Bryant St, Buffalo, NY 14222-2006 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740657360 | Pediatric Pulmonary Medicine PC | Pediatrics | 90 Fulton Blvd, Commack, NY 11725-1711 | 2015-08-31 |
| 1003221375 | Nooralam Ahmad Rai | Pediatrics | 3959 Broadway # Chc701, New York, NY 10032-1559 | 2014-06-25 |
| 1316289812 | Daniel Aaron Krich | Pediatrics | 40 Sunshine Cottage Rd # 1n-e29, Valhalla, NY 10595-1524 | 2013-03-22 |
| 1497037279 | Arthur Deluca Md Pediatric Pulmonology of Long Island | Pediatrics | 3016 37th St, Third Floor, Astoria, NY 11103-3809 | 2011-09-16 |
| 1912224924 | Pelton Phinizy | Pediatrics | 3959 Broadway Ave., Pediatric Pulmonary Division 7th Floor, New York, NY 10032-3725 | 2010-04-29 |
| 1013153238 | Aisha Sultana Baig | Pediatrics | 750 East Adam St, Syracuse, NY 13210 | 2008-12-17 |
| 1639321847 | Marleine Ishak | Pediatrics | 3330 Bainbridge Ave, Montefiore Medical Center, Bronx, NY 10467-2800 | 2008-10-21 |
| 1629252291 | Katharina D. Graw-panzer | Pediatrics | 505 E 70th St Fl 3, New York, NY 10021 | 2007-12-19 |
| 1497969786 | Kristin Kelly-pieper | Pediatrics | 267-01 76th Avenue, Cohen Children's Medical Center, New Hyde Park, NY 11040 | 2007-05-09 |
| 1457574477 | Ikr Pediatric Allergy & Pulmonology PC | Pediatrics | 301 East 66th Street, New York, NY 10021 | 2007-04-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.