Provider Demographics
NPI:1326109158
Name:SWEENEY, JOAN D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:D
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1174
Mailing Address - Country:US
Mailing Address - Phone:610-882-0284
Mailing Address - Fax:610-882-0218
Practice Address - Street 1:826 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1174
Practice Address - Country:US
Practice Address - Phone:610-882-0284
Practice Address - Fax:610-882-0218
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD061497L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001996644Medicaid
PA001996644Medicaid
PA012180Medicare UPIN