Doctor Name: | MRS. LIDIA SWINKIN |
NPI Number: | 1215273933 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS. ED |
License Number: | |
Business Practice Address: | 360 Bayport Ave Bayport, NY - 117051404 |
Business Phone Number: | 6314724246 |
Business Fax Number: | |
Mailing Address: | 360 Bayport Ave, BAYPORT |
State: | NY |
Postal Code: | 117051404 |
Phone Number: | 6314724246 |
Fax Number: | |
NPI Enumeration Date: | 12/28/2012 |
NPI Last Update Date: | 12/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |