MEDICARE: MS. SHARENE R LEWIS M.S.,CCC-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	NY 11747-1	NY

General Provider Information

NPI Number	:	1538312608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARENE R LEWIS M.S.,CCC-SLP

Provider Business Mailing Address
First Line	:	9151 115TH ST
Second Line	:
City	:	RICHMOND HILL
State	:	NY
Zip	:	11418-3138
Country	:	US
Telephone Number	:	917-617-3733
Fax Number	:	718-441-0474

Provider Business Practice Location Address
First Line	:	9151 115TH ST
Second Line	:
City	:	RICHMOND HILL
State	:	NY
Zip	:	11418-3138
Country	:	US
Telephone Number	:	917-617-3733
Fax Number	:	718-441-0474

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

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	11/03/2008

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Directions to “ MS. SHARENE R LEWIS M.S.,CCC-SLP” Practice Location

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