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NPI Code Detail

MEDICARE: ANDREA K SCHWAN

MEDICARE: ANDREA K SCHWAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1252Y00000XEarly Intervention Provider Agency638131121NY

General Provider Information

NPI Number : 1063755155
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA K SCHWAN
Provider Business Mailing Address
First Line : 132 ARLO RD
Second Line : APT 2B
City : STATEN ISLAND
State : NY
Zip : 10301-3805
Country : US
Telephone Number : 718-801-3050
Fax Number :
Provider Business Practice Location Address
First Line : 132 ARLO RD
Second Line : APT 2B
City : STATEN ISLAND
State : NY
Zip : 10301-3805
Country : US
Telephone Number : 718-801-3050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2013
Last Update Date : 03/27/2013

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