Healthcare Provider Details

I. General information

NPI: 1265540348
Provider Name (Legal Business Name): NADYA G SWEDAN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 11/05/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 PARK AVE SECOND FLOOR
NEW YORK NY
10128-1001
US

IV. Provider business mailing address

1065 PARK AVE SECOND FLOOR
NEW YORK NY
10128-1001
US

V. Phone/Fax

Practice location:
  • Phone: 212-289-0700
  • Fax: 212-289-0171
Mailing address:
  • Phone: 212-289-0700
  • Fax: 212-289-0171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number2035361
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: