Provider Demographics
NPI:1942378500
Name:SHERIDAN SURGICAL INC
Entity Type:Organization
Organization Name:SHERIDAN SURGICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-836-8780
Mailing Address - Street 1:4513 BAILEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-2187
Mailing Address - Country:US
Mailing Address - Phone:716-836-8780
Mailing Address - Fax:716-836-8620
Practice Address - Street 1:4513 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2127
Practice Address - Country:US
Practice Address - Phone:716-836-8780
Practice Address - Fax:716-836-8620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0813460001Medicare ID - Type Unspecified