MEDICARE: MR. THOMAS MICHAEL SWEENEY RPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2509	CT
2	2251G0304X	Geriatric Physical Therapist	2509	CT
3	2251N0400X	Neurology Physical Therapist	2509	CT
4	2251S0007X	Sports Physical Therapist	2509	CT
5	2251X0800X	Orthopedic Physical Therapist	2509	CT
6	225400000X	Rehabilitation Practitioner	2509	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	650008236	OTHER	CT	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	36401	OTHER	CT	ORTHONET/CIGNA
2	7647500001	OTHER	CT	CIGNA GROUP #
3	CONN605700112	OTHER	CT	PRIVATE HEALTH CARE SYS
4	015353	OTHER	CT	CTCARE
5	C009365	OTHER	CT	CHAMPUS
6	119457	OTHER	CT	AETNA
8	080002509CT02	OTHER	CT	ANTHEM
9	ANC1648	OTHER	CT	OXFORD HEALTH PLANS
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	CT154333	OTHER	CT	PREFERRED HEALTH NETWORK
12	104554200	OTHER	CT	WCUSPS1
13	OV1296	OTHER	CT	HEALTHNET

General Provider Information

NPI Number	:	1184627671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS MICHAEL SWEENEY RPT

Provider Business Mailing Address
First Line	:	506 CROMWELL AVE
Second Line	:	SUITE 103
City	:	ROCKY HILL
State	:	CT
Zip	:	06067-1851
Country	:	US
Telephone Number	:	860-721-9801
Fax Number	:	860-721-8475

Provider Business Practice Location Address
First Line	:	506 CROMWELL AVE
Second Line	:	SUITE 103
City	:	ROCKY HILL
State	:	CT
Zip	:	06067-1851
Country	:	US
Telephone Number	:	860-721-9801
Fax Number	:	860-721-8475

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	12/07/2010

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