Provider Demographics
NPI:1417027624
Name:SWANSON, ARTHUR J (PHD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:J
Last Name:SWANSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 EXETER PL
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2003
Mailing Address - Country:US
Mailing Address - Phone:718-652-0227
Mailing Address - Fax:718-652-9275
Practice Address - Street 1:WEILER - DEPT. OF PSYCHIATRY
Practice Address - Street 2:4119 WHITE PLAINS ROAD
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466
Practice Address - Country:US
Practice Address - Phone:718-652-0227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008066103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist