Individual
MR. RAYMOND CHARLES SWIFT III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
127 SYRACUSE AVE, MEDFORD, NY 11763-3626
(631) 949-4790
Mailing address
127 SYRACUSE AVE, MEDFORD, NY 11763-3626
(631) 949-4790
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
307530
NY
Other
Enumeration date
05/19/2012
Last updated
05/19/2012
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