Provider Demographics
NPI:1821449422
Name:SHARI, KEIKO (SPECIAL EDUCATION)
Entity Type:Individual
Prefix:
First Name:KEIKO
Middle Name:
Last Name:SHARI
Suffix:
Gender:F
Credentials:SPECIAL EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 HICKS ST
Mailing Address - Street 2:APT. 316
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6659
Mailing Address - Country:US
Mailing Address - Phone:646-285-1159
Mailing Address - Fax:
Practice Address - Street 1:414 HICKS ST
Practice Address - Street 2:APT. 316
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6659
Practice Address - Country:US
Practice Address - Phone:646-285-1159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1032000161174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator