Provider Demographics
NPI:1184627671
Name:SWEENEY, THOMAS MICHAEL (RPT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:506 CROMWELL AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1851
Mailing Address - Country:US
Mailing Address - Phone:860-721-9801
Mailing Address - Fax:860-721-8475
Practice Address - Street 1:506 CROMWELL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1851
Practice Address - Country:US
Practice Address - Phone:860-721-9801
Practice Address - Fax:860-721-8475
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2509225100000X, 2251G0304X, 2251N0400X, 2251S0007X, 2251X0800X, 225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT36401OtherORTHONET/CIGNA
CT7647500001OtherCIGNA GROUP #
CTCONN605700112OtherPRIVATE HEALTH CARE SYS
CT015353OtherCTCARE
CTC009365OtherCHAMPUS
CT119457OtherAETNA
CT650008236OtherMEDICARE RR
CT080002509CT02OtherANTHEM
CTANC1648OtherOXFORD HEALTH PLANS
CT004062030Medicaid
CTCT154333OtherPREFERRED HEALTH NETWORK
CT104554200OtherWCUSPS1
CTOV1296OtherHEALTHNET
CT104554200OtherWCUSPS1
CT7647500001OtherCIGNA GROUP #