Provider Demographics
NPI:1285875906
Name:SZWEDO, ROSE ANNE (PT)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:ANNE
Last Name:SZWEDO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1092
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-0059
Mailing Address - Country:US
Mailing Address - Phone:518-435-1295
Mailing Address - Fax:518-435-1295
Practice Address - Street 1:71 CASCADE TER
Practice Address - Street 2:
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-1976
Practice Address - Country:US
Practice Address - Phone:518-469-5367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007063-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics