Provider Demographics
NPI:1629365366
Name:SHEEHY, JOHN P JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:P
Last Name:SHEEHY
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:217 CENTRAL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-6925
Mailing Address - Country:US
Mailing Address - Phone:631-454-4560
Mailing Address - Fax:631-454-4552
Practice Address - Street 1:217 CENTRAL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-6925
Practice Address - Country:US
Practice Address - Phone:631-454-4560
Practice Address - Fax:631-454-4552
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY033553183500000X
NJ28R103200300183500000X
NC12893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist