Basic Information
| Provider Information | |||||||||
| NPI: | 1023088242 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWEENEY | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | LOUIS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 108 PITNEY AVE | ||||||||
| Address2: | |||||||||
| City: | SPRING LAKE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077621729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7324494590 | ||||||||
| FaxNumber: | 7327762328 | ||||||||
| Practice Location | |||||||||
| Address1: | 1945 STATE ROUTE 33 | ||||||||
| Address2: | |||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077534859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327764510 | ||||||||
| FaxNumber: | 7327762329 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 25MB04116600 | NJ | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.