Provider Demographics
NPI:1437302403
Name:SHELDON MED-SURGE PC
Entity Type:Organization
Organization Name:SHELDON MED-SURGE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:SIROTA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-791-1593
Mailing Address - Street 1:30 E SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1220
Mailing Address - Country:US
Mailing Address - Phone:516-791-1593
Mailing Address - Fax:516-791-5836
Practice Address - Street 1:30 E SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1220
Practice Address - Country:US
Practice Address - Phone:516-791-1593
Practice Address - Fax:516-791-5836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0929912086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty