Provider Demographics
NPI:1699414615
Name:SHEEHY, PHILIP (MSED)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:
Last Name:SHEEHY
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 OSAGE LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-6124
Mailing Address - Country:US
Mailing Address - Phone:718-813-8624
Mailing Address - Fax:
Practice Address - Street 1:42 OSAGE LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6124
Practice Address - Country:US
Practice Address - Phone:718-813-8624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist