Provider Demographics
NPI:1831257914
Name:GREGORY C. SWEENEY, M.D. P.C.
Entity type:Organization
Organization Name:GREGORY C. SWEENEY, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-696-3300
Mailing Address - Street 1:5 N JUNIATA ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-1901
Mailing Address - Country:US
Mailing Address - Phone:814-696-3300
Mailing Address - Fax:814-696-4229
Practice Address - Street 1:5 N JUNIATA ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-1901
Practice Address - Country:US
Practice Address - Phone:814-696-3300
Practice Address - Fax:814-696-4229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0400576261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAD71068Medicare UPIN
PA071660Medicare PIN