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General NPI Number Information
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NPI Number | 1306131420
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Entity Type | Individual
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Provider Name | VICTOR HUGO SWENSON III LSW
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Gender | Male
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Dates
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Enumeration Date | 06/16/2011
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Last Update Date | 06/16/2011
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Provider Practice Location Address
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Address Line | 149 E 78TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-0405
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Country | US
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Telephone | 212-879-4900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 95
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City | LIBERTY CORNER
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State | NJ
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Zip | 07938-0095
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Country | US
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Telephone | 908-581-9306
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL05478700
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License Number State | NJ
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