Provider Demographics
NPI:1609072909
Name:SWIFT-SENOR, JANE L
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:L
Last Name:SWIFT-SENOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 HUSCHKE RD
Mailing Address - Street 2:
Mailing Address - City:HURLEYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12747-5218
Mailing Address - Country:US
Mailing Address - Phone:845-434-0002
Mailing Address - Fax:845-434-0002
Practice Address - Street 1:164 HUSCHKE RD
Practice Address - Street 2:
Practice Address - City:HURLEYVILLE
Practice Address - State:NY
Practice Address - Zip Code:12747-5218
Practice Address - Country:US
Practice Address - Phone:845-434-0002
Practice Address - Fax:845-434-0002
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179403-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY179413OtherLICENSE#
NY02224871Medicaid