MEDICARE: MS. SHARI BLAIR STEIN-BALLOW MA,OTR/L

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	174400000X	Specialist	002464-1	NY

General Provider Information

NPI Number	:	1669627659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARI BLAIR STEIN-BALLOW MA,OTR/L

Provider Business Mailing Address
First Line	:	20 CONGRESS ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2716
Country	:	US
Telephone Number	:	646-331-9842
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 CONGRESS ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2716
Country	:	US
Telephone Number	:	646-331-9842
Fax Number	:

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

Provider Enumeration Date	:	11/18/2008
Last Update Date	:	11/18/2008

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