Provider Demographics
NPI:1164527719
Name:SWEARINGEN, MATTHEW THOMAS (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:THOMAS
Last Name:SWEARINGEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 WALNUT ST
Mailing Address - Street 2:STE 103
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2545
Mailing Address - Country:US
Mailing Address - Phone:607-333-6038
Mailing Address - Fax:
Practice Address - Street 1:139 WALNUT ST
Practice Address - Street 2:STE 103
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2545
Practice Address - Country:US
Practice Address - Phone:607-333-6038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010840-2111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ900056649OtherMEDICARE
NMC10840-9WOtherWORKER'S COMP. #
NYJ900056649OtherMEDICARE