Provider Demographics
NPI:1497091037
Name:SWEETING, DOUGLAS LLOYD (RD, CDN)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:LLOYD
Last Name:SWEETING
Suffix:
Gender:M
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 FISHERMANS CRK
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-2112
Mailing Address - Country:US
Mailing Address - Phone:315-383-5020
Mailing Address - Fax:
Practice Address - Street 1:18 FISHERMANS CRK
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-2112
Practice Address - Country:US
Practice Address - Phone:315-383-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-01
Last Update Date:2013-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007588-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered