Provider Demographics
NPI:1972397313
Name:SWEETING, STEPHANIE JOY
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:JOY
Last Name:SWEETING
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10915 MERRICK BLVD APT 6E2ND
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-3047
Mailing Address - Country:US
Mailing Address - Phone:347-624-1038
Mailing Address - Fax:
Practice Address - Street 1:10915 MERRICK BLVD APT 6E2ND
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11433-3047
Practice Address - Country:US
Practice Address - Phone:347-624-1038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X, 174N00000X
NY613128163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No172V00000XOther Service ProvidersCommunity Health Worker
No174N00000XOther Service ProvidersLactation Consultant, Non-RN