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General NPI Number Information
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NPI Number | 1316699671
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Entity Type | Individual
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Provider Name | SHIRA SWERDLIK MSPAS
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Gender | Female
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 2000 N VILLAGE AVE STE 301
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-1001
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Country | US
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Telephone | 516-678-8777
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Fax |
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Provider Business Mailing Address
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Address Line | 700 OLD COUNTRY ROAD 203
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City | PLAINVIEW
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State | NY
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Zip | 11803-4932
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Country | US
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Telephone | 516-967-1011
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 028184
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 028184
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License Number State | NY
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