Provider Demographics
NPI:1689273203
Name:SWEENEY, MARC LEE (PA-C)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:LEE
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-723-7600
Mailing Address - Fax:585-334-6373
Practice Address - Street 1:50 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9312
Practice Address - Country:US
Practice Address - Phone:585-723-7600
Practice Address - Fax:585-334-6373
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2020-12-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY024923363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical