Provider Demographics
NPI:1316376783
Name:SHERIDAN, MARGARET (RN IBCLC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WEBSTER PL
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3900
Mailing Address - Country:US
Mailing Address - Phone:908-267-8763
Mailing Address - Fax:
Practice Address - Street 1:7 WEBSTER PL
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3900
Practice Address - Country:US
Practice Address - Phone:908-267-8763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJL33695163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant