Provider Demographics
NPI:1003855370
Name:SWEENEY-MCDONOUGH, MAUREEN F (C-APN)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:F
Last Name:SWEENEY-MCDONOUGH
Suffix:
Gender:F
Credentials:C-APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 LARCH ST
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-1603
Mailing Address - Country:US
Mailing Address - Phone:908-245-7562
Mailing Address - Fax:
Practice Address - Street 1:608 LARCH ST
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-1603
Practice Address - Country:US
Practice Address - Phone:908-245-7562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08629100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health