Provider Demographics
NPI:1801875067
Name:SWEENEY, RALPH EDWARD JR (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:EDWARD
Last Name:SWEENEY
Suffix:JR
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 1:1122 SOUTH AVE W
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1419
Mailing Address - Country:US
Mailing Address - Phone:908-232-2700
Mailing Address - Fax:908-232-3763
Practice Address - Street 1:1122 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1419
Practice Address - Country:US
Practice Address - Phone:908-232-2700
Practice Address - Fax:908-232-3763
Is Sole Proprietor?:No
Enumeration Date:2006-01-15
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA36239174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ173142Medicare PIN
NJD19602Medicare UPIN