Provider Demographics
NPI:1295180115
Name:SWARUP, ABHISHEK (MD)
Entity Type:Individual
Prefix:DR
First Name:ABHISHEK
Middle Name:
Last Name:SWARUP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RICHMOND ST APT 2038
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-4101
Mailing Address - Country:US
Mailing Address - Phone:404-574-9661
Mailing Address - Fax:
Practice Address - Street 1:736 CAMBRIDGE STREET
Practice Address - Street 2:ST. ELIZABETH'S MEDICAL CENTER
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-789-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA111519002086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery