MEDICARE: DR. ROBERT A. SWIERUPSKI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	312785	NY
2	207R00000X	Internal Medicine Physician	223943	MA
3	207R00000X	Internal Medicine Physician	37974	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	93329	OTHER		FALLON
2	AA34789	OTHER		HPHC
3	J28722	OTHER	MA	MABC
4	468248	OTHER		TUFTS
5	000000030457	OTHER		BMC HEALTHNET
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	6594681	OTHER		CIGNA
8	412722	OTHER		RIBCHIP

General Provider Information

NPI Number	:	1134143092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT A. SWIERUPSKI M.D.

Provider Business Mailing Address
First Line	:	403 LAKE AVE
Second Line	:
City	:	SAINT JAMES
State	:	NY
Zip	:	11780-2205
Country	:	US
Telephone Number	:	631-862-7062
Fax Number	:	631-862-7114

Provider Business Practice Location Address
First Line	:	403 LAKE AVE
Second Line	:
City	:	SAINT JAMES
State	:	NY
Zip	:	11780-2205
Country	:	US
Telephone Number	:	631-862-7062
Fax Number	:	631-862-7114

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	12/17/2024

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