# FLEETWOOD MEDICAL CARE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134897028
- **Authorized official:** AWADHESH K GUPTA MD (OWNER)
- **Authorized official phone:** (917) 414-0953

## Contact information

- **Practice address:** 504 GRAMATAN AVE, MOUNT VERNON, NY 10552-3009
- **Practice address phone:** (917) 414-0953
- **Practice address fax:** (914) 668-1616
- **Mailing address:** 350 W 50TH ST APT 2GG, NEW YORK, NY 10019-4730
- **Mailing address phone:** (917) 414-0953
- **Mailing address fax:** (914) 665-1616

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/03/2021
- **Last updated:** 09/03/2021