Basic Information
Provider Information
NPI: 1588606917
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHETYE
FirstName: SWAPNIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 270
Address2:  
City: MASSAPEQUA PARK
State: NY
PostalCode: 117620270
CountryCode: US
TelephoneNumber: 6312642035
FaxNumber: 6312641418
Practice Location
Address1: 3201 KINGS HWY
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112342625
CountryCode: US
TelephoneNumber: 7185913072
FaxNumber: 7185913074
Other Information
ProviderEnumerationDate: 06/11/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X227612NYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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