MEDICARE: SHIRLEY L GARNER

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	225700000X	Massage Therapist	023937	NY

General Provider Information

NPI Number	:	1831953470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRLEY L GARNER

Provider Business Mailing Address
First Line	:	875 MORRISON AVE APT 4F
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-4405
Country	:	US
Telephone Number	:	917-600-7164
Fax Number	:

Provider Business Practice Location Address
First Line	:	69 E 130TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10037-3714
Country	:	US
Telephone Number	:	212-236-4769
Fax Number	:

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

Provider Enumeration Date	:	02/13/2024
Last Update Date	:	02/13/2024

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Directions to “ SHIRLEY L GARNER ” Practice Location

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