Provider Demographics
NPI:1538837802
Name:SHEERAN, MATTHEW NICHOLAS (PA-C)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:NICHOLAS
Last Name:SHEERAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 CURRY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1794
Mailing Address - Country:US
Mailing Address - Phone:201-227-1299
Mailing Address - Fax:201-227-0077
Practice Address - Street 1:440 CURRY AVE STE A
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1794
Practice Address - Country:US
Practice Address - Phone:201-227-1299
Practice Address - Fax:201-227-0077
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00638900207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty