MEDICARE: MS. CHRISTINA ALICIA SWABY M.S., A.T.,C

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	2255A2300X	Athletic Trainer	001426	NY

General Provider Information

NPI Number	:	1790904621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA ALICIA SWABY M.S., A.T.,C

Provider Business Mailing Address
First Line	:	710 E 102ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-2608
Country	:	US
Telephone Number	:	917-751-3472
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 E 102ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-2608
Country	:	US
Telephone Number	:	917-751-3472
Fax Number	:

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

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	07/08/2007

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