Provider Demographics
NPI:1174547772
Name:SWEDLER, JANE (MD)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:SWEDLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 STATION PLZ N
Mailing Address - Street 2:SUITE 611
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3808
Mailing Address - Country:US
Mailing Address - Phone:516-663-2532
Mailing Address - Fax:516-663-2233
Practice Address - Street 1:222 STATION PLZ N
Practice Address - Street 2:SUITE 611
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3808
Practice Address - Country:US
Practice Address - Phone:516-663-2532
Practice Address - Fax:516-663-4409
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1807862080A0000X, 207Q00000X, 207QA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01358341Medicaid