MEDICARE: SHARON LORD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	2355SO801X	NY
2	2355S0801X	Speech-Language Assistant	2355S0801X	NY

General Provider Information

NPI Number	:	1124396080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON LORD

Provider Business Mailing Address
First Line	:	8811 BAYVIEW PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3441
Country	:	US
Telephone Number	:	917-680-9241
Fax Number	:

Provider Business Practice Location Address
First Line	:	8811 BAYVIEW PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3441
Country	:	US
Telephone Number	:	917-680-9241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2011
Last Update Date	:	12/07/2011

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Directions to “ SHARON LORD ” Practice Location

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