Healthcare Provider Details

I. General information

NPI: 1992010136
Provider Name (Legal Business Name): ABHISEK SWAIKA MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17660 UNION TPKE STE 360
FRESH MEADOWS NY
11366-1531
US

IV. Provider business mailing address

17660 UNION TPKE STE 360
FRESH MEADOWS NY
11366-1531
US

V. Phone/Fax

Practice location:
  • Phone: 718-460-2300
  • Fax: 347-225-9930
Mailing address:
  • Phone: 718-312-3442
  • Fax: 347-225-9930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME115903
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number290157-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: