Provider Demographics
NPI:1417163106
Name:MCSWEENEY, JANE ALICE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:ALICE
Last Name:MCSWEENEY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:ALICE
Other - Last Name:MCSWEENEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPNP
Mailing Address - Street 1:33 RIDGEBURY RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-5517
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:293 ROUTE 100
Practice Address - Street 2:104
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-3213
Practice Address - Country:US
Practice Address - Phone:914-277-3360
Practice Address - Fax:914-277-1813
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP3810671363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics