MEDICARE: JUDY SWEET

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	174400000X	Specialist

General Provider Information

NPI Number	:	1578824660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY SWEET

Provider Business Mailing Address
First Line	:	40 FARLEY DR
Second Line	:
City	:	STONY POINT
State	:	NY
Zip	:	10980-1425
Country	:	US
Telephone Number	:	845-429-4944
Fax Number	:	845-947-4489

Provider Business Practice Location Address
First Line	:	40 FARLEY DR
Second Line	:
City	:	STONY POINT
State	:	NY
Zip	:	10980-1425
Country	:	US
Telephone Number	:	845-429-4944
Fax Number	:	845-947-4489

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

Provider Enumeration Date	:	06/05/2012
Last Update Date	:	06/05/2012

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Directions to “ JUDY SWEET ” Practice Location

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