MEDICARE: JANICE H. SHERIDAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F333507-1	NY

General Provider Information

NPI Number	:	1558684571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE H. SHERIDAN

Provider Business Mailing Address
First Line	:	1020 7TH NORTH ST
Second Line	:
City	:	LIVERPOOL
State	:	NY
Zip	:	13088-6192
Country	:	US
Telephone Number	:	315-451-3906
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 7TH NORTH ST
Second Line	:
City	:	LIVERPOOL
State	:	NY
Zip	:	13088-6192
Country	:	US
Telephone Number	:	315-451-3906
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	03/04/2010

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Directions to “ JANICE H. SHERIDAN ” Practice Location

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