Provider Demographics
NPI:1871547398
Name:SWEENEY, JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY APC-12
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-793-4810
Mailing Address - Fax:401-351-5928
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY APC-12
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-793-4810
Practice Address - Fax:401-351-5928
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD08484207ZB0001X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIJS03973Medicaid
RIJS03973Medicaid
RI007009182Medicare ID - Type UnspecifiedGROUP# 229006185
RI007009183Medicare ID - Type UnspecifiedGROUP# 229006187