Basic Information
| Provider Information | |||||||||
| NPI: | 1407242571 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RICHARD L SWERDLIK MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 302 MANOR RD | ||||||||
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| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103142408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188151000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 130 BRIGHTON BEACH AVE STE 3 | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112358067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189467557 | ||||||||
| FaxNumber: | 7188158122 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2015 | ||||||||
| LastUpdateDate: | 04/15/2015 | ||||||||
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| AuthorizedOfficialLastName: | SWERDLIK | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7188151000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 16677 | NY | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.