MEDICARE: YVES-LINE AUGUSTE-SWANN MD

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	207Q00000X	Family Medicine Physician	241021	MA
2	207R00000X	Internal Medicine Physician	045962	CT
3	207R00000X	Internal Medicine Physician	298100	NY

General Provider Information

NPI Number	:	1992989081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVES-LINE AUGUSTE-SWANN MD

Provider Business Mailing Address
First Line	:	3007 FARRAGUT RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-1537
Country	:	US
Telephone Number	:	718-434-0711
Fax Number	:	718-434-0722

Provider Business Practice Location Address
First Line	:	3007 FARRAGUT RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210
Country	:	US
Telephone Number	:	718-434-0711
Fax Number	:	718-434-0722

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

Provider Enumeration Date	:	12/26/2007
Last Update Date	:	08/20/2019

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