Healthcare Provider Details

I. General information

NPI: 1982298766
Provider Name (Legal Business Name): MADELINE CLARE SWEENEY APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 02/23/2021
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 PRINCETON PIKE STE 1D
LAWRENCEVILLE NJ
08648-2300
US

IV. Provider business mailing address

214 MELROSE AVE
MIDDLESEX NJ
08846-1847
US

V. Phone/Fax

Practice location:
  • Phone: 609-912-1500
  • Fax:
Mailing address:
  • Phone: 732-236-0580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ01072500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NJ01072500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: