Individual
DR. TRACY SHERMAN SHEEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7381 S BROADWAY, RED HOOK, NY 12571-1745
(845) 758-8818
(845) 758-9215
Mailing address
7381 S BROADWAY, RED HOOK, NY 12571-1745
(845) 758-8818
(845) 758-9215
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
VUT005760
NY
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
VUT005760
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10032271
CDPHP
NY
01
—
597054
MVP
NY
01
—
903534
BLOCK
NY
01
—
903535
BLOCK
NY
01
—
C211C1
BC/BS
NY
01
—
VUT005760
LICENSE NUMBER
NM
Enumeration date
01/24/2006
Last updated
11/02/2007
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