Provider Demographics
NPI:1205151248
Name:GHANTA, SWAPNA (MD)
Entity type:Individual
Prefix:
First Name:SWAPNA
Middle Name:
Last Name:GHANTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:32 STRAWBERRY HILL CT
Mailing Address - Street 2:4TH FLOOR, STE 8
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902
Mailing Address - Country:US
Mailing Address - Phone:203-276-4255
Mailing Address - Fax:203-276-4259
Practice Address - Street 1:32 STRAWBERRY HILL CT
Practice Address - Street 2:4TH FLOOR, STE 8
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-276-4255
Practice Address - Fax:203-276-4259
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2023-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY264313208600000X
CT73303208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery