MEDICARE: SHELDON DEAKIN

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	343900000X	Non-emergency Medical Transport (VAN)	343900000X	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609308352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELDON DEAKIN

Provider Business Mailing Address
First Line	:	57 CANNON ST UNIT 221
Second Line	:
City	:	POUGHKEEPSIE
State	:	NY
Zip	:	12601-3262
Country	:	US
Telephone Number	:	347-780-8775
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 CANNON ST UNIT 221
Second Line	:
City	:	POUGHKEEPSIE
State	:	NY
Zip	:	12601-3262
Country	:	US
Telephone Number	:	347-780-8775
Fax Number	:

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

Provider Enumeration Date	:	03/31/2017
Last Update Date	:	03/31/2017

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Directions to “ SHELDON DEAKIN ” Practice Location

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