1629204581 NPI number — ROBERT B SWERSKY MD PC

Table of content: (NPI 1629204581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629204581 NPI number — ROBERT B SWERSKY MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT B SWERSKY MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629204581
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 NORTHERN BLVD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
MANHASSET
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11030-3001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-365-4616
Provider Business Mailing Address Fax Number:
516-365-1759

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 NORTHERN BLVD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
MANHASSET
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11030-3001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-365-4616
Provider Business Practice Location Address Fax Number:
516-365-1759
Provider Enumeration Date:
06/05/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SWERSKY
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
B
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
516-365-4616

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X , with the licence number:  116612 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208G00000X , with the licence number: 116612 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)