Individual
DR. ROM M GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17660 UNION TPKE STE 350, FRESH MEADOWS, NY 11366-1531
(718) 521-6200
Mailing address
17561 HILLSIDE AVE STE 402, JAMAICA, NY 11432-5769
(718) 291-0488
(718) 291-0888
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
189770
NY
207RG0100X
Gastroenterology Physician
Primary
189770
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01417876
—
NY
Enumeration date
12/07/2005
Last updated
08/15/2025
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