Provider Demographics
NPI:1962503995
Name:SVEEN, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:SVEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5770 COMMONS PARK
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9400
Mailing Address - Country:US
Mailing Address - Phone:315-445-1577
Mailing Address - Fax:315-445-4862
Practice Address - Street 1:5770 COMMONS PARK
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9400
Practice Address - Country:US
Practice Address - Phone:315-445-1577
Practice Address - Fax:315-445-4862
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206012207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01754407Medicaid
NM206012OtherLICENSE
CC9344Medicare PIN
G45590Medicare UPIN