Provider Demographics
NPI:1659132306
Name:SHEEHAN, LUCAS (PHARMD)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:
Last Name:SHEEHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 LASKA LN
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5353
Mailing Address - Country:US
Mailing Address - Phone:603-714-1233
Mailing Address - Fax:
Practice Address - Street 1:141 WASHINGTON AVENUE EXT STE 3
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5610
Practice Address - Country:US
Practice Address - Phone:518-869-4697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist