Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 021072-01 | NY |
NPI | 1225572720 |
---|---|
Provider Name | Paul Swinnerton |
First Address | Staten Island, NY 10303-1506 |
Second Address | Staten Island, NY 10303-1506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2016 |
Last Update Date | 06/02/2020 |