Provider Demographics
NPI:1699014878
Name:SWEENEY, GERALDINE (OD)
Entity Type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-6137
Mailing Address - Country:US
Mailing Address - Phone:631-225-5828
Mailing Address - Fax:631-225-5271
Practice Address - Street 1:350 E MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-6137
Practice Address - Country:US
Practice Address - Phone:631-225-5828
Practice Address - Fax:631-225-5271
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004202-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist