Provider Demographics
NPI:1114142122
Name:SHEEHAN, WILLIAM E JR (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:SHEEHAN
Suffix:JR
Gender:M
Credentials:OD
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Other - Credentials:
Mailing Address - Street 1:2921 ERIE BLVD E
Mailing Address - Street 2:C/O EMPIRE VISION CENTER INC, P.C.
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1430
Mailing Address - Country:US
Mailing Address - Phone:315-445-7465
Mailing Address - Fax:315-445-7675
Practice Address - Street 1:1 SCAMMELL ST
Practice Address - Street 2:MASS OPTOMETRIC ASSOCIATES, P.C.
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-6706
Practice Address - Country:US
Practice Address - Phone:617-773-1353
Practice Address - Fax:617-773-1309
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA3004152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW15997Medicare ID - Type Unspecified
MAU42777Medicare UPIN