Basic Information
| Provider Information | |||||||||
| NPI: | 1275796120 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWIFT | ||||||||
| FirstName: | IRENE | ||||||||
| MiddleName: | QUIAMBAO PERMUT | ||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | QUIAMBAO PERMUT | ||||||||
| OtherFirstName: | IRENE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 200 HYGEIA DRIVE | ||||||||
| Address2: | CCHS PHYSICIAN CONTRACTING, SUITE 2300 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564291800 | ||||||||
| FaxNumber: | 8564291081 | ||||||||
| Practice Location | |||||||||
| Address1: | 4745 OGLETOWN-STANTON ROAD | ||||||||
| Address2: | MAP 1, SUITE 220 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023685515 | ||||||||
| FaxNumber: | 3023257056 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2008 | ||||||||
| LastUpdateDate: | 12/23/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 25MA09531200 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | 25MA09531200 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RS0012X | 25MA09531200 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RP1001X | C1-0011513 | DE | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.