Basic Information
| Provider Information | |||||||||
| NPI: | 1417052051 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWEET | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | N.P.-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 212 CHURCHILL LN | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130662539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3156377933 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 713 HARRISON ST | ||||||||
| Address2: | |||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132102305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154643153 | ||||||||
| FaxNumber: | 3154643178 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F332284 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.