MEDICARE: MRS. SHARI GRACE LINDO

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	2255A2300X	Athletic Trainer
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1386356566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARI GRACE LINDO

Provider Business Mailing Address
First Line	:	241 E BROADWAY
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4227
Country	:	US
Telephone Number	:	516-543-8650
Fax Number	:

Provider Business Practice Location Address
First Line	:	241 E BROADWAY
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4227
Country	:	US
Telephone Number	:	516-543-8650
Fax Number	:

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

Provider Enumeration Date	:	12/19/2022
Last Update Date	:	01/09/2023

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Directions to “ MRS. SHARI GRACE LINDO ” Practice Location

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