Individual
ANJALI GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
17 E 102ND ST, NEW YORK, NY 10029-5204
(212) 659-8551
(212) 824-2317
Mailing address
1 GUSTAVE L LEVY PL, BOX 3000, NEW YORK, NY 10029-6504
(212) 987-3100
(212) 731-5210
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207510
NY
207R00000X
Internal Medicine Physician
25MA07665900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095125UPA
MEDICARE INDIVIDUAL NUM
NJ
Enumeration date
12/13/2007
Last updated
12/03/2013
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