Healthcare Provider Details

I. General information

NPI: 1144589037
Provider Name (Legal Business Name): ELEANORE MALETTA SWANK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 10/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN-STANTON RD CHRISTIANA HOSPITAL STE 2A00
NEWARK DE
19718
US

IV. Provider business mailing address

60 BUTTERNUT HOLLOW
GREENWICH CT
06830
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1042
  • Fax: 302-733-1068
Mailing address:
  • Phone: 202-302-3127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD60546896
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: