Healthcare Provider Details

I. General information

NPI: 1871547398
Provider Name (Legal Business Name): JOSEPH SWEENEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST DEPARTMENT OF PATHOLOGY APC-12
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

593 EDDY ST DEPARTMENT OF PATHOLOGY APC-12
PROVIDENCE RI
02903-4923
US

V. Phone/Fax

Practice location:
  • Phone: 401-793-4810
  • Fax: 401-351-5928
Mailing address:
  • Phone: 401-793-4810
  • Fax: 401-351-5928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberMD08484
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberMD08484
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: