Provider Demographics
NPI:1104002153
Name:SHELDEN, JOAN BARBARA (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:BARBARA
Last Name:SHELDEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:JOAN
Other - Middle Name:BARBARA
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6167 W QUAKER ST
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2640
Mailing Address - Country:US
Mailing Address - Phone:716-662-4800
Mailing Address - Fax:716-662-5700
Practice Address - Street 1:6167 W QUAKER ST
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2640
Practice Address - Country:US
Practice Address - Phone:716-662-4800
Practice Address - Fax:716-662-5700
Is Sole Proprietor?:No
Enumeration Date:2008-01-20
Last Update Date:2008-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4532174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist