Provider Demographics
NPI:1508044553
Name:SHEEHAN, AMY (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 GREY ST., SANA PHYSICAL THERAPY
Mailing Address - Street 2:STE 5
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052
Mailing Address - Country:US
Mailing Address - Phone:716-671-7262
Mailing Address - Fax:716-671-7263
Practice Address - Street 1:123 GREY ST., SANA PHYSICAL THERAPY
Practice Address - Street 2:STE 5
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052
Practice Address - Country:US
Practice Address - Phone:716-671-7262
Practice Address - Fax:716-671-7263
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026211-1225100000X
NY026211-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01182512Medicaid
NY335182OtherMEDICARE PROVIDER ID