Provider Demographics
NPI:1154904399
Name:SHAKESPEARE, SYDNEY (DPM)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:
Last Name:SHAKESPEARE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:BEALS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:720 US HIGHWAY 202/206
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-1746
Mailing Address - Country:US
Mailing Address - Phone:908-704-8778
Mailing Address - Fax:908-704-8172
Practice Address - Street 1:2315 ROUTE 34
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1444
Practice Address - Country:US
Practice Address - Phone:732-974-0404
Practice Address - Fax:732-449-4271
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00381000213ES0103X
OH36.004123213ES0103X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery