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Individual

MR. JOHN J SWEENEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.D. , C.D.N.

Contact information

Practice address
930 JASMINE LN, SOUTHOLD, NY 11971-3071
(631) 765-1267
Mailing address
930 JASMINE LN, SOUTHOLD, NY 11971-3071
(631) 765-1267

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
001098-1
NY
133V00000X
Registered Dietitian
Primary
721012
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9256E1
MEDICARE PROVIDER NUMBER
NY
Enumeration date
02/19/2009
Last updated
02/19/2009
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