Healthcare Provider Details

I. General information

NPI: 1629204581
Provider Name (Legal Business Name): ROBERT B SWERSKY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NORTHERN BLVD SUITE 201
MANHASSET NY
11030-3001
US

IV. Provider business mailing address

1201 NORTHERN BLVD SUITE 201
MANHASSET NY
11030-3001
US

V. Phone/Fax

Practice location:
  • Phone: 516-365-4616
  • Fax: 516-365-1759
Mailing address:
  • Phone: 516-365-4616
  • Fax: 516-365-1759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number116612
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number116612
License Number StateNY

VIII. Authorized Official

Name: DR. ROBERT B SWERSKY
Title or Position: MD
Credential: MD
Phone: 516-365-4616