Healthcare Provider Details

I. General information

NPI: 1558326405
Provider Name (Legal Business Name): STEVEN G SWEITZER P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 04/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 POWELL AVE
NEWBURGH NY
12550-3412
US

IV. Provider business mailing address

861 BEDFORD RD
PLEASANTVILLE NY
10570-2700
US

V. Phone/Fax

Practice location:
  • Phone: 845-569-3663
  • Fax: 845-569-3352
Mailing address:
  • Phone: 914-773-3005
  • Fax: 845-569-3352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number000143
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number011395
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: