Provider Demographics
NPI:1437418100
Name:SWITZ, GENEVIEVE M (PA)
Entity Type:Individual
Prefix:MS
First Name:GENEVIEVE
Middle Name:M
Last Name:SWITZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:FALLSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12733-0116
Mailing Address - Country:US
Mailing Address - Phone:845-434-2080
Mailing Address - Fax:
Practice Address - Street 1:325 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:FALLSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12733
Practice Address - Country:US
Practice Address - Phone:845-434-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00411-1261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care