Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 25MA02605900 | NJ |
NPI | 1033327275 |
---|---|
Provider Name | Dr. Martin James Sheehy III |
First Address | Westfield, NJ 07090-2139 |
Second Address | Westfield, NJ 07090-2139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2007 |
Last Update Date | 08/07/2007 |