MEDICARE: OLUWATOBI SWAIN CRNA

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	367500000X	Certified Registered Nurse Anesthetist	RN761760	PA

General Provider Information

NPI Number	:	1801721816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWATOBI SWAIN CRNA

Provider Business Mailing Address
First Line	:	1104 BROOKWOOD LN
Second Line	:
City	:	SECANE
State	:	PA
Zip	:	19018-3511
Country	:	US
Telephone Number	:	732-470-5116
Fax Number	:

Provider Business Practice Location Address
First Line	:	1104 BROOKWOOD LN
Second Line	:
City	:	SECANE
State	:	PA
Zip	:	19018-3511
Country	:	US
Telephone Number	:	732-470-5116
Fax Number	:

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

Provider Enumeration Date	:	06/13/2026
Last Update Date	:	06/13/2026

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