Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 023605 | NY |
NPI | 1023660081 |
---|---|
Provider Name | Mr. Brendan William Swan |
First Address | Hoboken, NJ 07030-6670 |
Second Address | New York, NY 10065-6007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2019 |
Last Update Date | 15/07/2019 |