Provider Demographics
NPI:1356907653
Name:SHERIDAN, MEGHAN PATRICIA
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:PATRICIA
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1476
Mailing Address - Country:US
Mailing Address - Phone:908-370-5521
Mailing Address - Fax:
Practice Address - Street 1:111 CLIFTON AVE STE 3
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3342
Practice Address - Country:US
Practice Address - Phone:973-239-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist