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Organization

SELMA J. SHERIDAN MD

Active
Parent organization
SELMA J. SHERIDAN MD
Other names
Eyewear Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
SELMA J. SHERIDAN MD
Authorized official
DR. SELMA J. SHERIDAN MD (OWNER)
(315) 343-9022
Entity
Organization

Contact information

Practice address
209 W 7TH ST, OSWEGO, NY 13126-3676
(315) 343-9022
Mailing address
209 W 7TH ST, OSWEGO, NY 13126-3676
(315) 343-9022

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
132758
NY
332H00000X
Eyewear Supplier
1121450001
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00554476
NY
Enumeration date
03/03/2008
Last updated
01/23/2014
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