Provider Demographics
NPI:1831796895
Name:SWIERKOWSKI, GUNNAR MARK
Entity type:Individual
Prefix:DR
First Name:GUNNAR
Middle Name:MARK
Last Name:SWIERKOWSKI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BREWSTER RD W
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-8021
Mailing Address - Country:US
Mailing Address - Phone:516-498-7817
Mailing Address - Fax:
Practice Address - Street 1:243 E 172ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8902
Practice Address - Country:US
Practice Address - Phone:718-294-0294
Practice Address - Fax:718-294-0295
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist