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General NPI Number Information
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NPI Number | 1982001236
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Entity Type | Individual
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Provider Name | LISA ANN SHEEHAN MS, ATC
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Gender | Female
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Dates
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Enumeration Date | 12/02/2014
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Last Update Date | 05/06/2022
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Provider Practice Location Address
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Address Line | 25 LESHIN LN
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City | HIGHTSTOWN
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State | NJ
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Zip | 08520-4001
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Country | US
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Telephone | 609-443-7738
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Fax |
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Provider Business Mailing Address
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Address Line | 508 GIORDANO AVE
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City | PARLIN
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State | NJ
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Zip | 08859-4108
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Country | US
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Telephone | 609-529-4126
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 25MT00160300
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License Number State | NJ
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