Provider Demographics
NPI:1669627659
Name:STEIN-BALLOW, SHARI BLAIR (MA,OTR/L)
Entity Type:Individual
Prefix:MS
First Name:SHARI
Middle Name:BLAIR
Last Name:STEIN-BALLOW
Suffix:
Gender:F
Credentials:MA,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2716
Mailing Address - Country:US
Mailing Address - Phone:646-331-9842
Mailing Address - Fax:
Practice Address - Street 1:20 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2716
Practice Address - Country:US
Practice Address - Phone:646-331-9842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002464-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist