MEDICARE: DR. STEVEN SWANCOAT DO

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
1	207V00000X	Obstetrics & Gynecology Physician	286283	NY

General Provider Information

NPI Number	:	1215352125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN SWANCOAT DO

Provider Business Mailing Address
First Line	:	82 FRANKLIN ST
Second Line	:	APT PH6
City	:	NEW YORK
State	:	NY
Zip	:	10013-3431
Country	:	US
Telephone Number	:	313-673-6450
Fax Number	:

Provider Business Practice Location Address
First Line	:	82 FRANKLIN ST
Second Line	:	APT PH6
City	:	NEW YORK
State	:	NY
Zip	:	10013-3431
Country	:	US
Telephone Number	:	313-673-6450
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2014
Last Update Date	:	04/29/2019

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