Provider Demographics
NPI:1982862850
Name:SWAINSON, RAYMOND (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:SWAINSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 EAST 54TH STREET
Mailing Address - Street 2:PHF
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:646-930-4606
Mailing Address - Fax:646-930-4055
Practice Address - Street 1:515 W 59TH ST
Practice Address - Street 2:APT 21 L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1047
Practice Address - Country:US
Practice Address - Phone:347-432-3910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA476661223G0001X
NY0510451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice