Healthcare Provider Details

I. General information

NPI: 1225449978
Provider Name (Legal Business Name): LAURIE ANN SWEENEY REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 WESTERN AVE STE 4B
ALBANY NY
12203-3536
US

IV. Provider business mailing address

1525 WESTERN AVE STE 4B
ALBANY NY
12203-3536
US

V. Phone/Fax

Practice location:
  • Phone: 518-416-7123
  • Fax:
Mailing address:
  • Phone: 518-416-7123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number3822251
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number3822251
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number3822251
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: