MEDICARE: MRS. MARJAN SHARIF

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1780302034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARJAN SHARIF

Provider Business Mailing Address
First Line	:	1201 HOWARD ST APT 306
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68102-2925
Country	:	US
Telephone Number	:	516-526-4736
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 HOWARD ST APT 306
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68102-2925
Country	:	US
Telephone Number	:	516-526-4736
Fax Number	:

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

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	08/22/2022

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Directions to “ MRS. MARJAN SHARIF ” Practice Location

Language	Start Address	Practice Location

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