Provider Demographics
NPI:1659334159
Name:SWERZ, PETER MARK I (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:MARK
Last Name:SWERZ
Suffix:I
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 WESTBURY AVE
Mailing Address - Street 2:
Mailing Address - City:CARLE PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11514-1401
Mailing Address - Country:US
Mailing Address - Phone:516-333-2233
Mailing Address - Fax:516-333-2318
Practice Address - Street 1:495 WESTBURY AVE
Practice Address - Street 2:
Practice Address - City:CARLE PLACE
Practice Address - State:NY
Practice Address - Zip Code:11514-1401
Practice Address - Country:US
Practice Address - Phone:516-333-2233
Practice Address - Fax:516-333-2318
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX19041Medicare ID - Type Unspecified