Provider Demographics
NPI:1003815713
Name:SHEEHY, LEEANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:LEEANN
Middle Name:
Last Name:SHEEHY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 ROYAL OAK CT.
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066
Mailing Address - Country:US
Mailing Address - Phone:724-538-8952
Mailing Address - Fax:
Practice Address - Street 1:213 EXECUTIVE DRIVE
Practice Address - Street 2:STE 100, ATTN: OPTIMAL PHYSICAL THERAPY & SPORTS
Practice Address - City:CRANBERRY TWP.
Practice Address - State:PA
Practice Address - Zip Code:16066
Practice Address - Country:US
Practice Address - Phone:724-779-1300
Practice Address - Fax:724-779-1310
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001634E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P72431Medicare UPIN
PA064289Q5AMedicare ID - Type Unspecified