Provider Demographics
NPI:1013297654
Name:SWEENEY, AMY SUGARMAN (OD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUGARMAN
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ANNE
Other - Last Name:SWEENEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:19900 W CATAWBA AVE
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-4032
Practice Address - Country:US
Practice Address - Phone:704-892-8282
Practice Address - Fax:704-973-0028
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2250152W00000X
SC1671152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist