Provider Demographics
NPI:1841425287
Name:SWEENEY, MARY P (N P)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:P
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:N P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 N BEECH ST
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-2603
Mailing Address - Country:US
Mailing Address - Phone:516-799-9564
Mailing Address - Fax:
Practice Address - Street 1:4 DOROTHY GATE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-3521
Practice Address - Country:US
Practice Address - Phone:516-795-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300920-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health