MEDICARE: SHARI E JOHN MA CCC-A

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	237600000X	Audiologist-Hearing Aid Fitter

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659413516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARI E JOHN MA CCC-A

Provider Business Mailing Address
First Line	:	7 NORTEMA CT
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-2031
Country	:	US
Telephone Number	:	516-270-3583
Fax Number	:

Provider Business Practice Location Address
First Line	:	74-20 25TH AVE
Second Line	:
City	:	JACKSON HEIGHT
State	:	NY
Zip	:	11370-1428
Country	:	US
Telephone Number	:	718-350-3171
Fax Number	:	718-458-1367

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/08/2007

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Directions to “ SHARI E JOHN MA CCC-A” Practice Location

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