Provider Demographics
NPI:1467497503
Name:SWARNKAR, SUMAN A (MD)
Entity Type:Individual
Prefix:
First Name:SUMAN
Middle Name:A
Last Name:SWARNKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HARRISON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3188
Mailing Address - Country:US
Mailing Address - Phone:315-464-6527
Mailing Address - Fax:315-464-6529
Practice Address - Street 1:550 HARRISON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3188
Practice Address - Country:US
Practice Address - Phone:315-464-6527
Practice Address - Fax:315-464-6529
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214335207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02088975Medicaid
NY02088975Medicaid
NYCC1855Medicare PIN