MEDICARE: CARMEN SWIFT

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1770942807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN SWIFT

Provider Business Mailing Address
First Line	:	180 VAN CORTLANDT PARK S
Second Line	:	4C
City	:	BRONX
State	:	NY
Zip	:	10463-2435
Country	:	US
Telephone Number	:	917-859-3164
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 VAN CORTLANDT PARK S
Second Line	:	4C
City	:	BRONX
State	:	NY
Zip	:	10463-2435
Country	:	US
Telephone Number	:	917-859-3164
Fax Number	:

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

Provider Enumeration Date	:	02/17/2016
Last Update Date	:	02/17/2016

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Directions to “ CARMEN SWIFT ” Practice Location

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