Provider Demographics
NPI:1558498212
Name:SWARM, DOROTHY (RN)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:SWARM
Suffix:
Gender:F
Credentials:RN
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 104
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:10542-0104
Mailing Address - Country:US
Mailing Address - Phone:845-628-3848
Mailing Address - Fax:
Practice Address - Street 1:150 HILL ST
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-2716
Practice Address - Country:US
Practice Address - Phone:845-628-6427
Practice Address - Fax:845-208-3427
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY436841-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02381006Medicaid