Provider Demographics
NPI:1043489743
Name:DANIEL J. SHEEHAN, M.D. PC
Entity type:Organization
Organization Name:DANIEL J. SHEEHAN, M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-336-6874
Mailing Address - Street 1:1450 BARNUM AVE
Mailing Address - Street 2:SUITE 205-206
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-3239
Mailing Address - Country:US
Mailing Address - Phone:203-336-6874
Mailing Address - Fax:203-336-6875
Practice Address - Street 1:1450 BARNUM AVE
Practice Address - Street 2:SUITE 205-206
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-3239
Practice Address - Country:US
Practice Address - Phone:203-336-6874
Practice Address - Fax:203-336-6875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty