Provider Demographics
NPI:1396035267
Name:SWIENC, LUBA (PT)
Entity Type:Individual
Prefix:MS
First Name:LUBA
Middle Name:
Last Name:SWIENC
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HANOVER PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5839
Mailing Address - Country:US
Mailing Address - Phone:718-246-1470
Mailing Address - Fax:718-246-1481
Practice Address - Street 1:15 HANOVER PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5839
Practice Address - Country:US
Practice Address - Phone:718-246-1470
Practice Address - Fax:718-246-1481
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006005-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency