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General NPI Number Information
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NPI Number | 1164537767
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Entity Type | Individual
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Provider Name | LYNDA A SHERIDAN DPM
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 10/17/2019
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Provider Practice Location Address
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Address Line | 1033 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07013
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Country | US
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Telephone | 973-473-3344
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Fax | 973-473-8389
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Provider Business Mailing Address
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Address Line | 3-19 17TH STREET
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City | FAIR LAWN
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State | NJ
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Zip | 07410
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Country | US
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Telephone | 201-797-7351
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Fax | 973-773-9216
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 25MD00192600
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License Number State | NJ
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