MEDICARE: SHARON BAUM SLP

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	022165-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	022165-1	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1316382658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON BAUM SLP

Provider Business Mailing Address
First Line	:	1838 E 26TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-2438
Country	:	US
Telephone Number	:	347-410-2243
Fax Number	:

Provider Business Practice Location Address
First Line	:	1838 E 26TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-2438
Country	:	US
Telephone Number	:	347-410-2243
Fax Number	:

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

Provider Enumeration Date	:	04/30/2013
Last Update Date	:	04/30/2013

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Directions to “ SHARON BAUM SLP” Practice Location

Language	Start Address	Practice Location

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