Provider Demographics
NPI:1639845506
Name:SHERIDAN, CAITLIN (DPT)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 BROADHOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-5002
Mailing Address - Country:US
Mailing Address - Phone:631-359-5859
Mailing Address - Fax:
Practice Address - Street 1:1931 NEEDHAM ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02461
Practice Address - Country:US
Practice Address - Phone:617-303-0455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist