Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 12933 | RI |
N | 207N00000X | Dermatologist | 216892 | MA |
NPI | 1033192976 |
---|---|
Provider Name | Susan M Sweeney |
First Address | East Greenwich, RI 02818-5098 |
Second Address | East Greenwich, RI 02818-5098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2005 |
Last Update Date | 17/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110034608A | (05) | MA |
H87318 | (02) | MA |