Individual
JEAN EMELDA SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
619 MOUNT AVENUE, NORTH BABYLON, NY 11703
(631) 745-6005
Mailing address
619 MOUNT AVENUE, NORTH BABYLON, NY 11703
(631) 745-6005
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
396649-1
NY
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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