Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NN08629100 | NJ |
NPI | 1003855370 |
---|---|
Provider Name | Mrs. Maureen F Sweeney-Mcdonough |
First Address | Roselle Park, NJ 07204-1603 |
Second Address | Roselle Park, NJ 07204-1603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 15/11/2016 |