Healthcare Provider Details

I. General information

NPI: 1275542060
Provider Name (Legal Business Name): BRIAN SWEENEY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 KINSLEY ST
NASHUA NH
03060-3648
US

IV. Provider business mailing address

380 LAFAYETTE RD
HAMPTON NH
03842-2222
US

V. Phone/Fax

Practice location:
  • Phone: 603-595-3061
  • Fax: 603-889-3774
Mailing address:
  • Phone: 603-926-0088
  • Fax: 603-926-2853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number12358
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: