Provider Demographics
NPI:1124007307
Name:SHEEHY, MARY RITA (OD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:RITA
Last Name:SHEEHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 NEW HACKENSACK RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-1722
Mailing Address - Country:US
Mailing Address - Phone:845-297-4444
Mailing Address - Fax:845-297-7442
Practice Address - Street 1:187 NEW HACKENSACK RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-1722
Practice Address - Country:US
Practice Address - Phone:845-297-4444
Practice Address - Fax:845-297-7442
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-16
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004470-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY111019OtherEYE MED
NYC36411OtherEMPIRE BC/BS
NYP767683OtherOXFORD
NY901013OtherBLOCK VISION
NY318OtherDAVIS/CSEA
NY597132OtherMVP
NY901013OtherBLOCK VISION