MEDICARE: SWARN KUMAR GUPTA 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	207RP1001X	Pulmonary Disease Physician	137721	NY

General Provider Information

NPI Number	:	1093719742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SWARN KUMAR GUPTA M.D.

Provider Business Mailing Address
First Line	:	180 16 WEXFORD TERRACE
Second Line	:	SUITE CC
City	:	JAMAICA
State	:	NY
Zip	:	11432-3000
Country	:	US
Telephone Number	:	718-657-6434
Fax Number	:	718-657-5606

Provider Business Practice Location Address
First Line	:	18016 WEXFORD TER
Second Line	:	STE CC
City	:	JAMAICA
State	:	NY
Zip	:	11432-3004
Country	:	US
Telephone Number	:	718-657-6434
Fax Number	:	718-657-5606

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	09/29/2011

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