Healthcare Provider Details

I. General information

NPI: 1992943088
Provider Name (Legal Business Name): BETH ALLISON SWARTZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BETH ALLISON ZETLIN LMSW

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1276 FULTON AVE 6TH FLOOR
BRONX NY
10456-3402
US

IV. Provider business mailing address

1793 RIVERSIDE DR #5C
NEW YORK NY
10034-5335
US

V. Phone/Fax

Practice location:
  • Phone: 718-901-6112
  • Fax:
Mailing address:
  • Phone: 646-533-8017
  • Fax: 718-901-8864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0544591
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: