Provider Demographics
NPI:1649488792
Name:SHEELY, PENELOPE GAY (MD)
Entity type:Individual
Prefix:DR
First Name:PENELOPE
Middle Name:GAY
Last Name:SHEELY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-3521
Mailing Address - Country:US
Mailing Address - Phone:646-675-0179
Mailing Address - Fax:
Practice Address - Street 1:100 BUENA VISTA DR
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-3521
Practice Address - Country:US
Practice Address - Phone:646-675-0179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202748208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics