Provider Demographics
NPI:1639251952
Name:MACSWEENEY, MAUREEN A (MSN, CNM, ARNP)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:A
Last Name:MACSWEENEY
Suffix:
Gender:F
Credentials:MSN, CNM, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5341 CYPRESS RESERVE PL
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9428
Mailing Address - Country:US
Mailing Address - Phone:407-782-4990
Mailing Address - Fax:
Practice Address - Street 1:200 W 57TH ST STE 608
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3211
Practice Address - Country:US
Practice Address - Phone:917-410-6905
Practice Address - Fax:646-878-6095
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9305030363LW0102X, 367A00000X
CT000244367A00000X
NY002105367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004229630Medicaid
CT004229630Medicaid