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General NPI Number Information
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NPI Number | 1275946147
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Entity Type | Individual
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Provider Name | BRENDA J SHEEHAN ANP
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Gender | Female
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Dates
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Enumeration Date | 06/08/2014
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Last Update Date | 06/08/2014
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Provider Practice Location Address
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Address Line | 101 NICHOLLS RD SBUH, PALLIATIVE CARE SERVICE- HSC LEVEL T-15, RM.053
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City | STONY BROOK
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State | NY
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Zip | 11794-0001
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Country | US
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Telephone | 631-444-2292
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Fax | 631-444-3811
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Provider Business Mailing Address
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Address Line | 101 NICHOLLS RD SBUH, PALLIATIVE CARE SERVICE- HSC LEVEL T-15, RM.053
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City | STONY BROOK
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State | NY
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Zip | 11794-0001
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Country | US
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Telephone | 631-444-2292
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Fax | 631-444-3811
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 30305225
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License Number State | NY
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