Provider Demographics
NPI:1326013954
Name:SHERIDAN, JAMES MURPHY (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MURPHY
Last Name:SHERIDAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:895 WEST JERICHO TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787
Mailing Address - Country:US
Mailing Address - Phone:631-982-2022
Mailing Address - Fax:631-982-2024
Practice Address - Street 1:895 WEST JERICHO TURNPIKE
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787
Practice Address - Country:US
Practice Address - Phone:631-982-2022
Practice Address - Fax:631-982-2024
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158777208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036067905Medicaid