Healthcare Provider Details

I. General information

NPI: 1962273573
Provider Name (Legal Business Name): SWB PT,DC,OT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

286 MADISON AVE STE 1601
NEW YORK NY
10017-6374
US

IV. Provider business mailing address

286 MADISON AVE STE 1601
NEW YORK NY
10017-6374
US

V. Phone/Fax

Practice location:
  • Phone: 917-435-9452
  • Fax: 646-304-3203
Mailing address:
  • Phone: 917-435-9452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MISS CAITHA G BARR
Title or Position: THERAPIST
Credential: OT
Phone: 917-435-9452