Provider Demographics
NPI:1336433630
Name:SHEYDVASSER, JANET (MSED, MSW)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:SHEYDVASSER
Suffix:
Gender:F
Credentials:MSED, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 MILTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-5604
Mailing Address - Country:US
Mailing Address - Phone:917-349-1013
Mailing Address - Fax:
Practice Address - Street 1:223 MILTON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-5604
Practice Address - Country:US
Practice Address - Phone:917-349-1013
Practice Address - Fax:718-980-5434
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY545000111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist