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General NPI Number Information
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NPI Number | 1093674707
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Entity Type | Individual
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Provider Name | SWAPNA OMVED RAO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 790 RIDGE RD
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City | LACKAWANNA
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State | NY
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Zip | 14218-1629
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Country | US
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Telephone | 716-828-7404
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Fax | 716-828-7589
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Provider Business Mailing Address
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Address Line | 790 RIDGE RD
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City | LACKAWANNA
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State | NY
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Zip | 14218-1629
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Country | US
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Telephone | 716-828-7404
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Fax | 716-828-7589
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State | NY
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