Provider Demographics
NPI:1245895804
Name:SWEENEY, JOSE DAVID
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:DAVID
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 WEBER DR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1241
Mailing Address - Country:US
Mailing Address - Phone:202-878-2434
Mailing Address - Fax:
Practice Address - Street 1:4724 B ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5132
Practice Address - Country:US
Practice Address - Phone:202-878-2434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide